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What diagnostic tests are used to evaluate abnormal vaginal bleeding?
- A woman who has irregular menstrual periods requires a physical examination with a special emphasis on the thyroid,breast, and pelvic area. During the pelvic examination, the physician attempts to detect cervical polyps or any unusual masses in the uterus or ovaries.
- A Pap smear is also done to rule out cervical cancer. While the Pap smear is being obtained, samples might be taken from the cervix to test for the presence of infections such as chlamydia or gonorrhea.
- A pregnancy test is routine if the woman is premenopausal.
- A blood count may be done to rule out a low blood count (anemia) resulting from excessive blood loss.
- If something in the patient's (or her family's) medical background or physical examination raises a doctor's suspicion, tests to rule out certain blood clotting disorders may be done.
- Sometimes, a blood sample will be tested to evaluate thyroid function, liver function, or kidney function abnormalities.
- A blood test for progesterone levels or daily body temperature charting may be recommended to verify that the woman ovulates.
- If the doctor suspects that the ovaries are failing, such as with menopause, blood levels of follicle-stimulating hormone (FSH) may be tested.
- Additional blood hormone tests are done if the doctor suspects polycystic ovary, or if excessive hair growth is present.
- A pelvic ultrasound is often performed based on the woman's medical history and pelvic examination.
- If a woman does not adequately respond to medical treatment, if she is over age 40, or if she has persistent vaginal bleeding between her periods, a sampling of the lining of her uterus (termed endometrial sampling or endometrial biopsy) is often analyzed. Endometrial sampling helps to rule out cancer or precancer in the uterus, or it can confirm a suspicion that a woman is not ovulating.
Medically Reviewed by a Doctor on 2/17/2015