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Tests and diagnosis
By Mayo Clinic staffYour doctor will most likely ask about your medical history and menstrual cycles. You may be asked to keep a diary of bleeding and nonbleeding days, including notes on how heavy your flow was and how much sanitary protection you needed to control it. Your doctor will do a physical exam and may recommend one or more tests or procedures such as:
- Blood tests. A sample of your blood is evaluated in case excessive blood loss during menstruation has made you anemic. Tests may also be done to check for thyroid disorders or blood-clotting abnormalities.
- Pap test. Your doctor collects cells from your cervix for microscopic examination to detect infection, inflammation or changes that may be cancerous or may lead to cancer.
- Endometrial biopsy. Your doctor takes a sample of tissue from the inside of your uterus to be examined under a microscope.
- Ultrasound scan. This imaging method uses sound waves to produce images of your uterus, ovaries and pelvis.
Based on the results of your initial tests, your doctor may recommend further testing, including:
- Sonohysterogram. This ultrasound scan is done after fluid is injected through a tube into the uterus by way of your vagina and cervix. This allows your doctor to look for problems in the lining of your uterus.
- Hysteroscopy. A tiny tube with a light is inserted through your vagina and cervix into the uterus, which allows your doctor to see the inside of your uterus.
- Dilation and curettage (D and C). In this procedure, your doctor opens (dilates) your cervix and then inserts a spoon-shaped instrument (curet) into your uterus to collect tissue from the uterine lining. This tissue is examined in the laboratory.
Doctors can be certain of a diagnosis of menorrhagia only after ruling out other menstrual disorders, medical conditions or medications as possible causes or aggravations of this condition.
- Jurema M, et al. Menorrhagia. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- Excessive menstrual bleeding: Quick primer. National Women's Health Information Center. http://www.healthywomen.org/aub/pg1.html. Accessed April 25, 2009.
- Women and anemia — Heavy menstrual bleeding and fibroids. National Anemia Action Council. http://www.anemia.org/patients/featurearticles/content.php?contentid=000242§ionid=00015. Accessed April 25, 2009.
- Vaginal bleeding. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch242/ch242e.html. Accessed April 25, 2009.
- Abnormal uterine bleeding. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp095.cfm. Accessed April 25, 2009.
- Questions to ask about excessive menstrual bleeding. National Women's Health Information Center. http://www.healthywomen.org/aub/pg3.html. Accessed April 25, 2009.
- Menstrual periods fact sheet. The American College of Obstetricians and Gynecologists. Accessed April 25, 2009.
- Goodman A. Terminology and evaluation of abnormal uterine bleeding in premenopausal women. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- de Silva NK, et al. Definition and evaluation of abnormal uterine bleeding in adolescents. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/133793247-3/834086474/1524/248.html#4-u1.0-B978-0-323-02951-3..50040-6_1192. Accessed April 25, 2009.
- Cervical cancer screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/cervical/basic_info/screening/. Accessed April 25, 2009.
- Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2009.
