Diagnosing Heavy Menses

First a complete history will be taken along with a history of your current problem. Your physician will ask you a variety of questions to determine the history of your heavy menses. Here are some questions you may be asked:

* Have your last three menstrual periods been normal in timing and amount for you?
* How long do your periods usually last?
* How many days are there usually between your menstrual periods?
* How did this cycle (and others) differ from your usual menstruation?
* Have you passed blood clots?
* How many days has the bleeding lasted with these different or abnormal menstrual periods?
* How heavy have they been? How many pads and tampons have you been using per day?
* When was your last menstrual period?
* How old were you when had your first menstrual period?

General Health History

You may also be asked some more general health history questions like the following:

* Do you use birth control pills? Do you use an IUD for birth control?
* Do you take an estrogen supplement?
* Do you take aspirin more than once per week?
* Do you take Coumadin, heparin, or other anticoagulants?
* Have you recently given birth, had surgery, or experienced trauma on or near the vagina or uterus?

Testing

There are several tests that may be performed in determining the cause of your heavy menses. Most likely your physician will perform a routine pelvic exam (possibly including a Pap Smear). Other diagnostic tests that may be performed include but are not limited to:

* Endometrial biopsy
* Pelvic ultrasound
* Lab tests such as thyroid function tests, CBC, pregnancy test

A vaginal probe ultrasound only takes a few minutes, is not uncomfortable, and rapidly provides invaluable information. Frequently the diagnosis can be made on the basis of the pelvic exam and a pelvic ultrasound.

Depending on the findings at an initial visit, it may be necessary to run further tests during a second visit. It may help to look inside the uterus with a slender telescope called a hysteroscope that is inserted through the cervix. The ability to be able to see into the uterus in a quick office procedure is very basic to your OB/GYN.

Once the cause of bleeding is identified, your physician and you will discuss all of the treatment options available. Sometimes there can be heavy bleeding even if the uterus appears normal, but this can also be treated once we have eliminated other causes.

This information is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, or have any questions, please contact your obstetrician-gynecologist.