No period after cervical biopsy - LiveAcademy

More about the procedure

Cervical biopsy procedure

A biopsy is the removal of areas of altered tissue of the reproductive organs (cervix, endometrium) for subsequent study in order to make a diagnosis. With its help, you can identify any changes that have occurred to them, including at the cellular level.

A biopsy is performed in several ways, using various instruments, depending on the capabilities of the clinic and the existing need. But in any case, one of the results of the manipulation is tissue damage.

Hence, there is a high probability that the period that comes after the biopsy will look different. And the timing of their occurrence may also change.

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And if the doctor recommends it, you should not refuse this minor operation. An accurate diagnosis can only be determined by histological analysis of a piece of tissue obtained as a result of a biopsy of the cervix.

Effect on the timing of menstruation

The regular process of replacing the lining of the uterus is very easy to disrupt. It depends on many factors that are associated with the functioning of the nervous system, endocrine and, of course, reproductive system.

There is no doubt whether a biopsy can affect your period. There are several explanations for this:

• A biopsy is generally a low-traumatic procedure, but it is not done every day, so the bravest and calmest woman will inevitably experience anxiety associated with it. And stress can delay menstruation for a long time. For some types of it, intravenous anesthetics are prescribed, which will make it easy to endure the procedure, but it may interfere with the normalization of the cycle. Without pain relief, the postponement of menstruation is facilitated by the unpleasant sensations experienced.
• A delay in menstruation after a cervical biopsy can also occur due to some trauma to its epithelium. During menstruation, the mucous membrane of the organ cavity comes out. It would not be a mistake to assume that the biopsy involves the uterus itself. Mechanical injury requires tissue healing, and the resources of the reproductive system are directed toward it. Menstruation is now receding into the background.
• A cervical biopsy is not always to blame for its absence; a delay in menstruation can occur due to a disease that forced the manipulation. These include erosions, dysplasia, carcinomas, and oncological diseases.
• A delay in menstruation after a biopsy may be caused by complications. This is probably due to the negligence of the doctor, but more often it is the fault of the patient when she does not comply with the regime and hygiene. During the healing period, they are very important, since at the site of tissue collection there remains a wound that is easily susceptible to infection.
• Sometimes, if your period does not start after a biopsy, it makes sense to check for pregnancy. Before the procedure, specialists do many tests, but they can take the patient’s word for its absence. And women sometimes make mistakes in this regard.

Early arrival of menstruation

Some women notice not a delay, but a faster arrival of their periods. In this regard, people are interested in: can menstruation begin prematurely after a biopsy? This happens due to a hormonal imbalance caused by a stressful situation, when the level of estrogen and progesterone in the blood decreases, as well as hemoglobin.

It is important to monitor not only the consistency of the discharge and volume, but also the accompanying sensations. During menstruation, symptoms are noted in the mammary glands in the form of engorgement, drowsiness or irritability is felt.

If there is none of this, but bloody discharge occurs, is supplemented by an elevated temperature, and gradually acquires an unpleasant odor, it means that a complication has occurred after the manipulation. You need to bring it to the doctor before your appointment. There is likely to be an infection that will have to be treated before the underlying condition can be addressed.

Sometimes a woman feels like her period started earlier after the biopsy. In fact, it may be discharge resulting from the healing of a wound on the mucous membrane. They are usually watery, but contain blood, so they are similar to premenstrual spotting.

You can’t for 2 weeks or more (this depends on the level of tissue damage during biopsy):

• Carrying weights;
• Douche;
• Have sex;
• Use vaginal tampons for any purpose;
• To take a bath;
• Take a steam bath.

How do your periods go after a cervical biopsy? Normal consequences of the procedure

From this article you will learn about the dangers of bleeding after a cervical biopsy.

As a rule, a biopsy is prescribed to women when pathologies of the vagina or cervix are detected by colposcopy.

The procedure is a small surgical intervention, the purpose of which is to obtain a fragment of tissue and send it for subsequent histological examination. Heavy bleeding after a biopsy is quite rare and sometimes sutures are placed on the cervix to prevent it.

Moderate pain symptoms in the lower abdomen, as well as minor bleeding from the vagina, lasting no more than 10 days, are considered normal after a biopsy.

After a cervical biopsy performed on an outpatient basis, the patient is able to work or is released from work for 1–2 days.

After a biopsy of the cervix and curettage of the mucous membrane of the cervical canal (or separate diagnostic curettage), performed in a hospital setting, the patient is given a certificate of incapacity for work for up to 10 days.

Examination of the cervix using a speculum is performed 4–6 weeks after the biopsy. Sexual activity after excisional biopsy of the cervix is ​​possible after 4 weeks, after conization - after 6–8 weeks.

Because a biopsy is an invasive procedure that involves removing tissue samples using special sharp forceps or a large needle, some bleeding after a cervical biopsy procedure is normal. Bleeding after a biopsy may increase due to sexual activity, so it is recommended that you avoid sexual intercourse for the first week after the procedure.

In addition, for the entire period of uterine recovery after the cervical biopsy procedure, until vaginal bleeding stops, you must abandon tampons and use sanitary pads.

The use of lubricants and vaginal suppositories, douching is also not recommended - avoiding such substances helps speed up the healing process of cervical tissue after a biopsy.

Bleeding after cervical biopsy

You should call the clinic/your gynecologist immediately if:

Bloody discharge from the genital tract is heavier than your normal menstruation;

You have heavy bloody discharge from the genital tract or a lot of clots;

You have severe pain in the lower abdomen;

Body temperature above 37.5;

You notice an unusual discharge with an unpleasant odor

Cervical biopsy, what you should not do:

Lift weights over 3 kg

Have intimacy within the next 2 weeks

Go to the bathhouse, sauna, take a bath for the next 2 weeks (you can wash in the shower).

Take aspirin; This medication thins the blood and prevents blood clots from forming in the biopsy area, which can lead to prolonged/heavy bleeding.

Used to diagnose various pathologies of the reproductive system in women. This operation is invasive in nature, and therefore can provoke a number of complications. Cervical bleeding during the postoperative period is one of the most common among them.

Characteristics of the procedure

Biopsy is one of the histological diagnostic methods. The essence of the operation is to surgically obtain a sample for laboratory analysis - a small piece of tissue from the uterine cervix. The obtained material is further examined to identify signs of pathological processes.

The procedure is used to diagnose the following diseases:

• pathologies caused by the papilloma virus
• oncological diseases
• congenital anomalies of the uterus
• precancerous conditions
• infertility

There are different ways to perform a biopsy. Their distinctive features are the localization of the tissue section taken for analysis, the number of samples, and the method of introduction into the organ.

In some cases, a biopsy is strictly contraindicated. First of all, this applies to women who suffer from diseases associated with blood clotting disorders. The operation is contraindicated in acute cases. It is also not recommended to perform a biopsy if there are symptoms of disorders caused by taking hormonal drugs.

Before the procedure, the patient must undergo auxiliary medical examinations to determine the presence of contraindications. If necessary, they are treated, and only after that a biopsy is performed.

Negative consequences

Almost every woman develops various side effects after surgery. However, such ailments are mild in nature, and in the vast majority of cases disappear on their own.

The degree of intensity of symptoms in the postoperative period largely depends on the individual characteristics of the patient. A number of factors may indicate the presence of a pathological process after the procedure.

Symptoms of violations:

• in the pelvic area
• significant increase in temperature
• general malaise, weakness
• vaginal discharge with unpleasant odors
• release of blood clots

Carrying out manipulation

When the need for a procedure arises, the time for this is chosen based on:

• Availability of obtaining tissues necessary for study;
• Information content of the study;
• Possibilities for subsequent tissue healing.

Many women do not understand whether it is possible to do a biopsy during menstruation. After all, discharge can interfere with the analysis and distort its results. On the other hand, during this period the cervix is ​​softened and expanded, access to the changed tissues is open.

Taking this into account, a biopsy during menstruation is carried out most often, but it should be completed when there is a minimum of discharge, but the cervical canal is still slightly open. This period is also chosen by the specialist because one can be sure that the patient is not pregnant. It is undesirable to carry out manipulation in this state.

A biopsy during menstruation is also justified by the fact that at this stage it is physiological. During healing, nothing will interfere with it, since it takes 10-14 days and will occur during the non-menstrual period.

We recommend reading the article about the normal amount of blood released during menstruation. You will learn about the volume of discharge and its composition, as well as what can cause heavy or scanty menstruation.

Before menstruation

A cervical biopsy before menstruation is also possible. It is often done with a diagnosis of “erosion”, the treatment of which is carried out just in the last of the critical days. If changes in the epithelium are found on the outer surface of the organ, and the inner surface remains clean, the time of manipulation in the cycle does not matter much.

A cervical biopsy before menstruation can be prescribed when the examination must be done urgently, and its results can be obtained quickly. In this case, in addition to the usual tests for infections, flora and cytology, they also donate blood for hCG to exclude pregnancy.

A biopsy before menstruation is performed if it is necessary to examine the endometrium. In case of infertility, its tissues will give more information when they are taken on the 17-23rd day of the cycle, with heavy menstrual flow on the 10th, and suspicions of cancer and uterine bleeding do not imply a certain interval in the cycle at all.

Discharge and bleeding after cervical biopsy: norm and pathology

The nature of the discharge after a cervical biopsy indicates how successful the procedure was. Unpleasant sensations are considered normal for such an operation and represent the organ’s reaction to surgical intervention.

Cervical tissue damaged after a biopsy is a wound that heals and will make itself felt during the recovery period. Violation of the integrity of this organ is accompanied by secretions necessary for scarring and healing of the tissue.

What discharge is considered normal?

After the procedure, the woman’s body begins to recover, it’s similar to menstruation. During this period, the patient’s task is to monitor how many days the discharge continues, what color and volume it is.

Most often, the following discharges are considered normal:

• slight bleeding for several days;
• heavy discharge for 2-3 weeks;
• light yellow and brown spots;
• greenish spots.

How does the intensity of discharge depend on the type of biopsy?

The days of the menstrual cycle on which the procedure is performed affect the amount of discharge. In the first half of the menstrual cycle, it is safer to perform the procedure, and the cervix will recover faster.

Discharge after a cervical biopsy can be of different volumes and colors. This depends on the instruments used to perform the operation and the type of biopsy.

puncture

Features:

• a frequently used procedure that feels painless, so anesthesia is not needed;
• A sample of the material is taken from the patient using a special needle;
• a small wound remains that bleeds for 2 to 4 days.

Features of discharge:

• small bloody spots;
• scanty bleeding.

Conchotomnaya

The manipulation has a number of nuances:

• a painful procedure that takes place under local anesthesia using special scissors;
• After the manipulation, a small wound remains, which bleeds for about 7 days.

Features of discharge: pink, pink-red discharge during healing time.

Radio wave

Specifics of manipulation:

• prescribed to nulliparous and pregnant women;
• The basis of this painless procedure is electric current;
• After taking a sample of the cervix, the device seals the wound site.

Features of discharge:

• watery;
• less often - scanty bleeding for 3 days.

Laser

Features of manipulation:

• a painful procedure, performed under local anesthesia or general anesthesia;
• a non-traumatic type of biopsy: the wound obtained during the process is immediately sealed with a laser.

Features of discharge:

• white, brown discharge for 7 days;
• sometimes bloody discharge for 2-3 days.

Loop

Peculiarities:

• carried out with a special tool in the form of a loop;
• the procedure is painful, so local anesthesia is given;
• Due to the use of electric current, the manipulation leaves a scar on the cervix.

Features of discharge:

• bleeding 1-3 weeks;
• pink and brown discharge.

Wedge-shaped

A wedge biopsy is performed as follows:

• the procedure is performed under general, epidural or spinal anesthesia;
• the sample is taken with a scalpel;
• After the manipulation, a large triangular wound remains.

Features of discharge:

• heavy bleeding for 2 weeks;
• discharge is accompanied by pain in the lower abdomen.

Circular

The manipulation has the following specifics:

• According to reviews, this is a very painful procedure;
• during the process, spinal, general anesthesia, and epidural anesthesia are used;
• pain relief is given for several days after the biopsy;
• During the procedure, a large area of ​​tissue is cut out.

Features of discharge:

• heavy bleeding for 2-4 weeks;
• Severe pain is also observed.

Curettage (scraping)

The manipulation is carried out in this way:

• due to severe pain, intravenous anesthesia is performed;
• They expand the cervical canal and take scrapings from the mucous tissue of the cervix.

Features of discharge:

• scanty discharge for 5-10 days;
• may smear as during menstruation.

The complete absence of discharge after curettage is a pathology in which it is necessary to consult a doctor.

What recommendations should be followed during the recovery period?

Recommendations during the recovery period:

• You can’t lift weights or play sports;
• provide the body with rest for the first two days;
• It is prohibited to visit baths and saunas;
• do not take hot baths;
• for discharge, you can use pads;
• It is prohibited to use tampons.

Restrictions on sexual intercourse must be observed for 2 weeks after the manipulation, otherwise bleeding can be provoked.

Additional restrictions:

• It is not recommended to drink alcohol as it slows down the healing process;
• do not insert anything into the vagina (suppositories, ointments);
• do not use blood thinning medications;
• Douching should not be done.

To urgently stop bleeding, the doctor will most likely prescribe the drug Tranexam.

For what symptoms should you consult a doctor?

If you have any questions related to pain and the amount of discharge, you should consult a specialist.

Especially if the following symptoms are observed:

• prolonged discharge;
• heavy bleeding;
• burning and itching;
• elevated temperature;
• change in color and nature of discharge;
• abdominal pain;
• intense and prolonged periods;
• delay of menstruation.

Prolonged discharge

Allocations must be completed in accordance with established rules. If, with simple types of biopsy, the discharge should have ended in three days, but continues for a week, this means that the wound is not healing or complications have arisen.

Heavy bleeding

You should pay attention if the cervix is ​​bleeding. In a complex biopsy procedure, such as a wedge biopsy, heavy periods will be normal. Continuous blood of a rich red color indicates bleeding.

Burning and itching

Burning and itching are mostly symptoms of thrush. A doctor's consultation is required to confirm the diagnosis and find out what medications can be combined with rehabilitation of the body after a biopsy.

If the patient is already taking medications, it may be an allergy to the components of the drug. You should stop taking the medication before consultation.

Fever

A body temperature above 37.5°C that cannot be brought down is a pathology. An inflammatory process has begun in the body, which should be detected immediately.

When the temperature is low - 37 degrees, but lasts longer than a week, it is called subfebrile. It speaks of serious health problems. The problems may not be related to the cervix; a new inflammatory process has begun in the body.

Change in color and nature of discharge

Any change in consistency, color and volume of discharge requires attention. Poor blood clotting and infection will affect the structure of the discharge.

Dangerous symptoms:

• changed the color to a more saturated and dark one;
• there was an unpleasant smell of discharge;
• purulent discharge began;
• blood clots appeared on the pad;
• yellow discharge with a pungent odor.

Abdominal pain

Pain in the lower abdomen should not last longer than the established norm. If painkillers do not help or help for a short period of time, this is the development of a serious illness.

If your lower abdomen is tormented by cutting pains, you don’t have to endure them. This may also indicate a viral infection that requires urgent treatment.

Intense and prolonged periods

The first menstruation after the procedure may be more intense than usual. A strong deviation from the usual volume and constant pain is a pathology. Menstruation is a difficult process for the female body; if the wound does not heal, bleeding may occur.

Delay of menstruation

Not a deviation. The body is busy healing the wound, the menstrual cycle has faded into the background. You can consult a doctor if you are concerned that you have not had your period for more than two months.

Reasons for delay:

• woman's stress;
• body stress;
• tissue regeneration process;
• inflammatory process;
• infections;
• pathologies (dysplasia).

Victoria Vladimirovna Nikitina on the Family Doctor Clinic channel about cervical dysplasia.

Pregnancy after cervical biopsy

Features of pregnancy after biopsy:

1. After simple biopsy methods, you can become pregnant when the body’s rehabilitation is complete. This information can be clarified with your doctor after the procedure.
2. If a large area of ​​tissue was taken for analysis, pregnancy planning should be discussed with your doctor. He may advise you to delay conception and sexual activity until your cervix is ​​completely healed. The recovery period will increase and additional examinations - ultrasound - will be required.
3. During recovery, the uterus is most often incapable of fertilization. But if the patient becomes pregnant after the biopsy, there will be a risk of premature birth. Doctors put additional stitches on the wound to increase the chances of carrying a child.
4. For nulliparous girls, the most gentle analysis methods are now used. If the procedure and recovery went without complications, you can become pregnant.

First, before conception, you need to consult a gynecologist.

Photo gallery

Puncture Loop Conchotomic Wedge-shaped Curettage Radio wave

Consequences of the cervical biopsy procedure on the Moscow Doctor Clinic channel.

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Changes in the nature of menstruation

Menstruation after a cervical biopsy may retain its normal parameters. If the intervention was minimal, went well, completely painless and without anesthesia, the woman had no reason to fear, there is no reason for menstruation to change.

But this does not happen in all cases. Sometimes a significant amount of tissue is required for examination; they are taken from several places, which means that the epithelium is seriously damaged. And in complex cases, several layers are studied, which requires a wedge-shaped piece of tissue. Then you shouldn’t worry that your period came after the biopsy:

• A lot. The main reason leading to this is hormonal imbalance and tissue trauma. The cervix produces mucus normally, and damage to the epithelium increases its amount due to the need for healing. Heavy periods after a biopsy also occur with insufficient blood clotting, which can serve as a contraindication to the procedure. But if the doctor deems it necessary, he will do a study, and the patient’s menstruation will be intense.
• In smaller quantities compared to average. After a biopsy, scanty periods can be caused either by a nervous shock experienced, which affects the balance of hormones towards a decrease, or by a disease that provoked the need for examination. Sometimes women mistake for menstruation the discharge resulting from the healing of a wound on the epithelium.
• Long lasting. After a cervical biopsy, menstruation takes a long time if it was performed in the second phase of the cycle. At this stage, the endometrium is as thick and loose as possible. Intervention can prevent it from thinning and also disrupts hormonal balance. The discharge is long and uneven. The duration of the process is also provoked by injury to the epithelium. Watery discharge, characteristic of the healing of mucous membranes, is added to the menstrual discharge.

Implications for the cycle

Endometrial examination is a more complex and traumatic procedure. In addition, the part of the organ that is replaced during menstruation is directly affected. Accordingly, menstruation after an endometrial biopsy can present more surprises. A woman does not always understand whether this is postoperative bleeding or a full menstruation. But it is important that:

• The amount of discharge did not go beyond normal menstruation. The appearance of small clots is acceptable;
• There was no severe pain. Slight stretching in the abdominal area is normal;
• There was no foul smelling discharge or fever.

In order not to provoke difficulties with the cycle and complications, the regimen after manipulation of the endometrium is the same as when taking material from the cervical epithelium.

A problem that may arise with such a study is that there is no menstruation after a pipel biopsy. This method is the least expensive in terms of pain and manipulation time. But with it, it is possible to take layers of the endometrium from different parts of the uterus for examination, which provokes a longer wait for the critical days.

A pipel biopsy is done for:

• Endometriosis;
• Infertility;
• Intermenstrual bleeding, which itself can cause delay.

Your period following a biopsy should be monitored more closely than usual.

The manipulation itself is safe in principle; it has been carried out and helps in diagnosis for decades. A woman’s incorrect behavior afterward can lead to negative consequences, as can possible medical errors.

At the same time, you should not be afraid of the irreparable, the body will survive the stress, and everything will work out. But all doubts should be discussed in the doctor’s office and resolved there.

Uterine cancer. Cycle length. . We recommend reading the article about menstrual irregularities after cervical biopsy.

Menstruation after biopsy. Cervical dysplasia: treatment with traditional methods. . What is possible/not possible. Quantity/allocations. Cycle disruption. Pads/tampons.

Ectropion is a violation of the anatomy of the cervix, its inversion outward. . A cervical biopsy involves excision of a small area of ​​tissue to . From it you will learn about the impact of the disease on the menstrual cycle and the nature of discharge.

Quantity/allocations. Cycle disruption. Pads/tampons. . The procedure must be carried out with caution if dysplastic elements are found in the biopsy or smears from the cervix.

Quantity/allocations. Cycle disruption. Pads/tampons. Pain/pills. . Precise taking of biopsy smears from the cervix and vagina, which improves the quality of diagnosis of possible diseases.

Any manipulations on the cervix that are accompanied by its fixation. This includes curettage (including instrumental abortion), hysteroscopy, repeated biopsies, etc. Symptoms of cervical ectropion.

Previously asked:

Great article! Thanks to those who write such articles for us. Right now I’m 10 days late, I’ve scoured the entire Internet, looking for what’s wrong with me, because the tests are negative. I accidentally came across this article and it hit me! After my last period they took a biopsy.

Thank you for the article.

Thank you, very useful article. I had a biopsy done to clarify the diagnosis - grade 3 cervical dysplasia. After the cervical biopsy, periods began on time, but their period was longer. It's already the tenth day. Even after the biopsy, the doctor prescribed me to take Tranexam 500 mg 3 times a day for 5 days. I’m taking it for the second day, the discharge has become less, there’s a slight “smudge.” I hope everything gets better soon. Health to everyone!

A biopsy is a mini-surgical operation. It does not bring severe painful sensations, but during its implementation minor trauma to the functional layer of the uterus occurs. After the biopsy, the woman experiences spotting. In some cases, the procedure affects the nature of menstruation.

How do periods change after a uterine biopsy?

Many serious diseases of the reproductive system are not so easy to identify. For some pathologies, a general examination and tests are sufficient, but for others, even an ultrasound examination is not enough. Then a biopsy comes to the rescue.

This diagnostic method is painless and quick, but doctors characterize it as a minor surgical intervention. And as you know, after such manipulations a woman’s body experiences stress, as a result of which the level of hormones changes and a disruption of the menstrual cycle may occur.

About the biopsy

Aspiration biopsy of the endometrium and other organs affected by the disease is a diagnostic measure, during which a special instrument, a pipe, is inserted into the cavity of the reproductive system. Using the negative pressure it creates, the medical specialist takes a small piece of the affected tissue and sends it for histological examination to identify progressive pathology.

During the procedure, the patient does not feel intense pain, her reproductive organs are not damaged, and there is a minimal chance of triggering inflammatory processes.

Performing a biopsy during menstruation

On what day of the cycle is it better to take aspirate from the uterine cavity? Medical specialists are confident that the most favorable days when it is necessary to carry out a diagnostic procedure are days 8-13 of the menstrual cycle (its beginning occurs on the first day of the menstrual cycle). Then the affected tissues and wounds will have time to recover before the next critical day.

But sometimes there are emergency situations when doctors do a biopsy of the cervix or the internal cavity of the uterine body during menstruation. This event is unaesthetic, but quite acceptable and possible.

Impact on the arrival of menstruation

Any surgical intervention in the human body provokes a stressful state. Often, during severe shocks, the level of female hormonal elements changes significantly, which entails the irregularity of menstrual periods.

No discharge

It is not uncommon for women who have recently had an endometrial or cervical biopsy to experience a delay in their periods.

The main reason for this phenomenon is considered to be damage to the inner, protective lining of the uterine body (endometrium). It is she who is rejected and removed from the female body during the period of regulation. But if the integrity of the epithelial tissues is damaged, then the body will direct all its forces to heal the resulting wound, which will lead to the absence of menstruation.

The delay may be caused not by the diagnostic procedure, but by the disease leading to it. Most often this is:

• erosion;
• dysplasia;
• carcinoma;
• oncological diseases;
• benign formations (fibroids, polyps, cysts).

The absence of critical days may indicate that the doctor did not perform a biopsy or improper hygiene. After the biopsy, it is very important to follow all the doctor’s recommendations, keep the genitals clean and limit yourself from certain activities (sexual intercourse, lifting weights, intense sports).

Early periods

After an aspirate is taken from the patient for examination, menstruation may not only be absent, but may also occur too early.

This phenomenon can also occur due to hormonal imbalance. But it is very important for a woman to understand whether the discharge after a biopsy is menstrual.

If bleeding from the vagina is accompanied by an increase in breast volume, drowsiness, irritability and pulling sensations in the lower abdomen, then you should not worry.

However, if there are no such symptoms of PMS (premenstrual syndrome), then you should immediately consult a qualified gynecologist. Sometimes this phenomenon is uterine bleeding, which can result in serious and life-threatening consequences.

Elevated body temperature and the foul odor of bloody secretion may also indicate the presence of a pathological process. Most likely, these signs indicate that infectious microelements have entered the woman’s body. It is very important to visit a doctor promptly and receive proper medical care.

How menstruation changes

Sometimes periods after a cervical biopsy can noticeably change their character.

This occurs if during the procedure the woman was given certain types of pharmacological drugs, the diagnostic procedure was carried out by an inexperienced doctor, serious damage to the internal epithelium occurred, or a sample affected by pathology was taken from soft tissues in several places at once. It is not surprising then that the amount, duration or type of menstrual flow may vary. The following changes are most often observed.

• Excessively heavy menstruation - occurs as a result of serious hormonal imbalance and significant damage to internal tissues. The uterine cervix produces secretory fluid, and when the mucous membranes are injured, the synthesis of secretions increases significantly, which provokes more intense periods. This phenomenon is also observed if a woman has impaired blood clotting (often a contraindication for a biopsy).
• Scanty bleeding - the cause of this phenomenon, as a rule, is stress or progression of the disease, for the detection of which aspiration of the pelvic organs was prescribed. Also, girls often mistake normal discharge with blood particles that appear during the healing of the wound formed during the procedure for scanty menstruation.
• Prolonged menstruation - most often observed if internal examination was carried out during the second phase of the cycle. It is at this moment that the protective layer of the uterus, the endometrium, is the most loose, durable and thick. Intervention in the uterine cavity can provoke a worsening process of thinning of this layer and changes in hormone levels. That is why a woman will observe a prolonged flow of menstrual blood with a large amount of watery secretory fluid.