Bleeding again two weeks after period

We know that the average menstrual cycle for girls is 28 days. However, some girls may experience early or delayed menstruation. If they have two or three periods in a month, they should consider that excessive menstruation is caused by disease factors and they need to go to the hospital for treatment. While treating irregular menstruation, girls should also pay attention to changes in their lifestyle habits. So, what are the reasons why girls bleed again two weeks after their period?

1. Inspection

1. Gynecological examination

Conditions of the vulva, vagina, cervix, uterus, and adnexa, etc.

2. Auxiliary examination

(1) Laboratory examination: routine blood and urine examination. Patients of childbearing age often require urine or blood HCG testing to rule out pregnancy or pregnancy-related diseases. Depending on the situation, thyroid function, liver function, kidney function, coagulation function and sex hormone tests may also be required.

(2) Cervical cytology and HPV testing: Patients who have bleeding during sexual intercourse or cervical inflammation, polyps, or bleeding should undergo this examination, which can help diagnose early cervical cancer.

(3) Ultrasound examination: B-ultrasound (transabdominal or transvaginal): Patients with uterine bleeding often need to undergo pelvic B-ultrasound examination to understand the size and shape of the uterus, the thickness of the endometrium, whether there are abnormal echoes in the uterine cavity, whether there are masses in the adnexal area and the characteristics of the masses, whether there is abdominal effusion, etc.

(4) Biopsy: ① Lesions of the vulva, vagina, and cervix can be directly biopsied to confirm the diagnosis. If choriocarcinoma is suspected, biopsy should be avoided because uncontrollable massive bleeding from the lesion may occur. ② For patients with uterine bleeding, a diagnostic curettage is often required to confirm the diagnosis or stop bleeding (generally limited to married patients), and the scraped tissue must be subjected to pathological examination. For those suspected of endometrial cancer, segmental diagnostic curettage is performed. That is, the cervical canal is scraped first, then the depth of the uterine cavity is explored and the endometrial tissue is scraped. After the source of the specimens is marked, they are sent for pathological examination to assist in the diagnosis of endometrial cancer.

(5) Endoscopic examination: ① Hysteroscopic examination: When B-ultrasound shows abnormal uterine cavity echo, or when functional uterine bleeding has been diagnosed and long-term treatment has been ineffective, hysteroscopy is required. To determine whether there are any lesions in the uterine cavity, such as submucosal myoma, endometrial polyps, cancer, etc. ② Laparoscopic examination: If a pelvic mass or endometriosis is found during gynecological examination or B-ultrasound, laparoscopy can provide a definitive diagnosis.

2. Differential Diagnosis

To distinguish whether it is vaginal bleeding or urethral bleeding, a vaginal examination can determine the site of bleeding, and a routine urine test can determine whether it is a urinary tract problem.

3. Treatment principles

1. Etiological treatment, treatment targeted at the specific cause.

2. Symptomatic treatment, mainly hemostatic treatment.

3. If the amount of bleeding is large and the patient shows symptoms such as pale complexion, sweating, palpitations, dry mouth, etc., he should be sent to the hospital for diagnosis and treatment as soon as possible. Before arriving at the hospital, if the patient is feeling nauseous or vomiting, he or she should turn his or her face to one side to prevent suffocation.