What's wrong with bleeding after gynecological examination

Bleeding after gynecological examination may be related to factors such as cervical sampling, vaginal mucosal damage, endometrial irritation, cervical lesions, coagulation dysfunction, etc. Bleeding after gynecological examination can be treated by observing rest, local hemostasis, anti infection treatment, pathological examination, coagulation function regulation, and other methods.

1. Cervical Sampling

During cervical liquid based cytology or HPV testing, the sampler may scratch the surface of the cervix, causing capillary rupture. Manifested as a small amount of bright red blood or brown secretion, usually lasting 1-2 days. It is recommended to use medical gauze to compress and stop bleeding, and avoid sexual activity and baths within 24 hours. If the amount of bleeding exceeds the menstrual flow, timely follow-up is necessary.

2. Vaginal mucosal injury

Placement of a speculum or instrument operation may cause mechanical abrasion of the vaginal wall. Commonly seen in vaginal dryness or postmenopausal women, accompanied by a slight stinging sensation. Recombinant human epidermal growth factor gel can be used to promote mucosal repair, and metronidazole suppository can be placed in vagina to prevent infection if necessary. It is recommended to communicate with the doctor about the use of lubricants before the examination.

3. Endometrial stimulation

Uterine cavity procedures such as curettage and tubal patency may disturb the basal layer of the endometrium. Bleeding is mostly dark red with lower abdominal distension, lasting for 3-5 days, which is within the normal range. Yunnan Baiyao capsules can be taken to help stop bleeding, combined with hot compress to relieve spasms. Abnormal massive bleeding requires ultrasound to rule out uterine perforation.

4. Cervical lesions

Original cervical polyps and cervical columnar epithelial ectopia may cause contact bleeding during examination. Blood often appears as bright red droplets, which may recur. It is necessary to clarify the nature through vaginal colposcopy biopsy, and after diagnosis, cervical electrocoagulation or cryotherapy can be chosen. Regular follow-up of HPV and TCT is required after surgery.

5. Coagulation dysfunction

Patients with thrombocytopenia or those taking anticoagulant drugs are prone to persistent bleeding. Manifested as difficulty in coagulation of the wound and prolonged bleeding time. Four coagulation tests should be performed, and platelet transfusions should be administered if necessary. Long term use of warfarin requires adjusting the INR value to below 2.0 before invasive testing.

Avoid vigorous exercise and heavy physical labor within 3 days after gynecological examination, use pure cotton underwear and change it daily. Observe changes in bleeding volume. If there is fever, odor secretion, or bleeding exceeding menstrual flow, return to the hospital in a timely manner. To keep the external genitalia clean and dry, rinse the perineum 1-2 times a day with warm water. Pay attention to supplementing with iron containing foods such as animal liver and spinach to prevent anemia, and prohibit sexual activity and swimming within 2 weeks. It is recommended to choose a regular medical institution for physical examination, and proactively inform the doctor of the medical history and medication situation before the examination.