Menorrhagia (Heavy Bleeding)

Your healthcare provider will diagnose the cause of your heavy bleeding using the following steps:

Initial Evaluation

You will be asked about:

  • Your family and medical history, including past illnesses, medications, and birth control
  • Your lifestyle, eating,and exercise habits
  • Stress
  • Changes in body weight
  • Your menstrual periods

Your healthcare provider will also perform a physical exam, including a pelvic exam.

Tests

You may have one or more of the following tests:

  • Blood tests – to 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 in 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 healthcare provider to diagnose the cause of your amenorrhea. Evaluation usually includes the following:

Initial Evaluation

You will be asked about:

  • Your family and medical history, including past illnesses, medications, and birth control
  • Your lifestyle, eating, and exercise habits
  • Stress
  • Changes in body weight
  • Your menstrual periods

Your healthcare provider will also perform a physical exam, including a pelvic exam.

Pregnancy Test

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

Other Tests

Your healthcare provider 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

Testing for Causes of Your Menstrual Disorder

Other testing may include:

  • Imaging of the brain to evaluate the structure of the pituitary gland an important gland for hormone production and regulation. Sometimes a small tumor (noncancerous) can produce excess hormones that interfere with the normal menstrual cycle.
  • Ultrasound scans of your abdomen and pelvis to evaluate internal female organs as well as other glands
  • Chromosome studies