Menorrhagia (Heavy Bleeding)

Initial Evaluation

You will be asked about:

    
  • Your family and medical history
  • Your lifestyle, eating, and exercise habits
  • Stress
  • Changes in body weight
  • Your menstrual periods
  • Birth control
  • Your doctor will also do a physical exam, including a pelvic exam.

    Tests

    You may have one or more of the following tests:

        
  • Blood tests—Your doctor will measure levels of hormones and other factors in the blood, as well as to check for pregnancy.
  • Endometrial biopsy —A small amount of tissue is scraped from the lining of your uterus and examined under a microscope.
  • Ultrasound—A device that uses sound waves to create an image of your pelvic organ is placed on your abdomen or inside of your vagina.
  • Laparoscopy —A thin tube with a tiny camera attached is inserted through a small incision below or through your navel, allowing the doctor to look inside your abdomen.
  • Hysteroscopy —A thin tube with a tiny camera attached is inserted into your vagina and up through your cervix, allowing your doctor to see inside your uterus.
  • Amenorrhea (Lack of Menstruation)

    It may be difficult for your doctor to diagnose the cause of your amenorrhea . Evaluation usually includes the following:

    Initial Evaluation

    You will be asked about:

        
  • Your family and medical history
  • Your lifestyle, eating, and exercise habits
  • Stress
  • Changes in body weight
  • Your menstrual periods
  • Birth control
  • Your doctor will also perform a physical exam, including a pelvic exam.

    Tests

    The most common cause of secondary amenorrhea is pregnancy. If your menstrual period is at least 2-3 weeks overdue and you are sexually active, the first consideration is pregnancy.

    Your doctor may recommend testing your blood for hormone levels:

        
  • Androgen excess
  • Estrogen deficiency
  • Problems with the endocrine system (hormone production)
  • Prolactin in the blood
  • Thyroid hormone
  • Further Testing

    Other tests that may be done include:

        
  • Imaging of the brain to evaluate the pituitary gland—Sometimes a small, noncancerous growth can produce excess hormones that interfere with the normal menstrual cycle.
  • Ultrasound scans of your abdomen and pelvis
  • Chromosome studies