postcoital bleeding

性交後出血

WordNet

1. the flow of blood from a ruptured blood vessel (同)hemorrhage, haemorrhage

PrepTutorEJDIC

1. 出血する / 出血;放血

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/10 14:30:49」(JST)

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Gynecologic hemorrhage represents excessive bleeding of the female reproductive system. Such bleeding could be visible or external, namely bleeding from the vagina, or it could be internal into the pelvic cavity or form a hematoma. Normal menstruation is not considered a gynecologic hemorrhage, as it is not excessive. Hemorrhage associated with a pregnant state or during delivery is an obstetrical hemorrhage.

Definition

Menstruation occurs typically monthly, lasts 3–7 days, and involves up to 80 ml blood. Bleeding in excess of this norm in a nonpregnant woman constitutes gynecologic hemorrhage. In addition, early pregnancy bleeding has sometimes been included as gynecologic hemorrhage, namely bleeding from a miscarriage or an ectopic pregnancy, while it actually represents obstetrical bleeding. However, from a practical view, early pregnancy bleeding is usually handled like a gynecological hemorrhage.

Types

• Metrorrhagia (metro = womb, -rrhagia = excessive flow) is uterine bleeding at irregular intervals, particularly between the expected menstrual periods.
• Postcoital bleeding is vaginal bleeding triggered by sexual intercourse.

Causes

Causes of gynecologic bleeding include:

Hormonal

Anovulation is a common cause of gynecological hemorrhage. Under the influence of estrogen the endometrium (uterine lining) is stimulated and eventually such lining will be shed off (estrogen breakthrough bleeding). The anovulation chapter discusses its multiple possible causes. Longstanding anovulation can also lead to endometrial hyperplasia and facilitate the development of endometrial cancer.

Neoplasm

1. Cancer of the uterus is always a concern, specifically when the bleeding occurs after menopause. Other types of cancer include cervical cancer; bleeding in that case can sometimes be triggered by postcoital bleeding. Cancers of the vagina or fallopian tubes are rare causes of hemorrhage.
2. Uterine fibroids represent a common, benign condition that may lead to bleeding, specifically if the lesion affects the uterine cavity.
3. Polyps of the uterine lining are a common cause of bleeding, but such bleeding tends to be light.

Trauma

1. Sexual assault and rape can lead to injury and gynecological hemorrhage.
2. Accidents to the lower abdomen may lead to internal or external bleeding.

Bleeding disorder

Women with a bleeding disorder may be prone to more excessive bleeding. A hematologic work-up should discover the cause.

Other

On occasion an ovarian cyst can rupture and give rise to internal hemorrhage. This may occur during ovulation or as a result of endometriosis.

If the pregnancy test is positive, consider pregnancy related bleeding (see obstetrical hemorrhage), including miscarriage and ectopic pregnancy.

Diagnosis

A history will establish if the condition is acute or chronic, and if external circumstances are involved. A gynecologic examination is usually complemented by a gynecologic ultrasonography. A blood count determines the degree of anemia and may point out bleeding problems. The pregnancy test is important, particularly as bleeding in early pregnancy presents as gynecological hemorrhage and ectopic pregnancy can be fatal. Diagnosis is broadly classified into supportive and definitive investigations: Supportive 1 Complete blood count to assess degree of anemia

          2 ultrasonography to r/o uterine lesions,PID

Definitive 1 pregnancy test for those who are not yet post menopausal mandatory

          2 speculum examination to take samples for PAP smear
          3 D&C to get samples for histology and also control the bleeding if  associated with
            abortion.
          4 colposcopy

Prevention

Generally gynecologic hemorrhage does not arise out of nowhere. Regular gynecologic examinations, cancer screening, and contraceptive measures go a long way in preventing and forestalling unsuspected acute bleeding events.

First aid

Gynecologic hemorrhage needs to be evaluated as soon as possible by a physician. The amount and duration of bleeding will dictate whether a bleeding event is an emergency event.

Clinical treatment

Treatment depends on diagnosis and may include hormonal therapy, iv fluids, blood transfusion, and/or a dilation and curettage. Internal bleeding requires laparoscopy or abdominal surgery.

References

See also

• Medical emergency

UpToDate Contents

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• 1. 女性の性交後出血 postcoital bleeding in women
• 2. 女性における生殖器出血の原因の概要 overview of causes of genital tract bleeding in women
• 3. 閉経前女性における異常子宮出血の用語および評価 terminology and evaluation of abnormal uterine bleeding in premenopausal women
• 4. 急性子宮頚管炎 acute cervicitis
• 5. 子宮内避妊に関連する問題のマネージメント management of problems related to intrauterine contraception

English Journal

• Postcoital bleeding due to cervical endometriosis.

• Seval MM, Cavkaytar S, Atak Z, Guresci S.SourceDepartment of Obstetrics and Gynecology, Kecioren Education and Research Hospital, Ankara, Turkey.
• BMJ case reports.BMJ Case Rep.2013 Jan 31;2013. pii: bcr2012008209. doi: 10.1136/bcr-2012-008209.
• Endometriosis of the uterine cervix is a rare lesion that is generally asymptomatic in gynaecological practice. We present a case with postcoital bleeding due to a cervical mass mimicking cervical polyp or fibroma which was histologically proven as cervical endometriosis later. Cervical endometriosi
• PMID 23376669

• The relationship between urogenital symptoms and climacteric complaints.

• Oge T, Hassa H, Aydin Y, Yalcin OT, Colak E.SourceDepartments of Gynecology and Obstetrics.
• Climacteric : the journal of the International Menopause Society.Climacteric.2013 Jan 8. [Epub ahead of print]
• Objective To evaluate the relationship between urogenital symptoms and climacteric complaints, including anxiety, depression, somatic, vasomotor and sexual subscores according to the Greene Climacteric Scale (GCS). Methods We retrospectively reviewed the records of 1278 patients and the 908 patien
• PMID 23215751

Japanese Journal

• 卵管膨大部妊娠に対し卵管線状切開術後20日目に、性交を契機に再出血した一例

• 佐藤 健二,白石 悟
• 日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology 24(2), 318-321, 2008-12-01
• … BACKGROUND: The use of conservative surgical techniques to treat ectopic pregnancies has been reported to increase the rate of incomplete trophoblastic tissue removal and subsequent regrowth.<BR>CASE: Postcoital acute abdominal pain occurred in a woman treated with a laparoscopic linear salpingotomy without suturing for an ampullary ectopic pregnancy 20 days previously. … An emergency laparotomy was performed and a 600 ml hemoperitoneum was present The bleeding site of the prior salpingotomy was identified and closed. …
• NAID 10025692389

• 子宮頸部漿液性腺癌の1例

• 西本 秀明
• 日本臨床細胞学会雑誌 41(2), 122-126, 2002-03-22
• NAID 110001229701

• 子宮頚部しょう液性腺癌の１例

• 西本 秀明
• 日本臨床細胞学会雑誌 41(2), 122-126, 2002
• <B>背景:</B>漿液性腺癌は卵巣癌ではよくみられる組織型であるが, 子宮頸部原発の漿液性腺癌はきわめてまれである. 今回本症例を経験したので報告する.<BR><B>症例:</B>症例は35歳, 2経妊2産婦で主訴は性交後出血であった. 術前の細胞診では, 高度の異型を示す癌細胞がみられ, 腺管形成は認められるが, 充実性増殖は不明瞭で …
• NAID 130003926714

Related Links

• Postcoital Bleeding « Below the Belt: Women's Health

Whether the “wet spot” on the bed after sex turns out to be blood, or there is spotting on toilet paper when you wipe, bleeding after sex is a disconcerting climax to intimacy. There are two basic culprits that can cause bleeding after ...

• Postcoital bleeding - RightDiagnosis.com - Right Diagnosis

Causes of Postcoital bleeding with diagnosis analysis, related symptoms, patient stories, full-text book chapters, alternative diagnoses, misdiagnosis, treatments, remedies, and much more. ... Postcoital bleeding: Related Topics ...

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★リンクテーブル★

リンク元	「接触出血」
関連記事	「postcoital」

「接触出血」

　　[★]

英

contact bleeding

同

性交後出血 postcoital bleeding

• 主として性交などによる出血を指す。
• 腟壁や子宮腟部の炎症による粘膜の充血、あるいは子宮腟部びらんによるものが多い。子宮頚癌や膣癌が原因の場合もある。まずは、細胞診を行い、ついでコルポスコピーを行う。(NGY.134)

「postcoital」

　　[★]

• 性交後の

関

post-coitum、postcoitum、postcoitus