Dysfunctional Uterine Bleeding - Exams and Tests
Your doctor must first
rule out all
other medical causes of vaginal bleeding before
dysfunctional uterine bleeding (DUB).
First, your doctor will:
- Review your history of symptoms and menstrual
periods. (If possible, bring with you a record of the days you had your period,
how heavy or light the flow was, and how you felt each day.)
- Conduct a routine
- Find out whether you are
ovulating regularly. This is done using one or
more of the following:
- A daily record of your symptoms (menstrual
- A daily
basal body temperature chart, if you have been keeping
track at home. This charts your at-rest temperature.
progesterone test, because low levels during the third
week of a menstrual cycle suggest an ovulation problem
endometrial biopsy for
perimenopausal women, because abnormal endometrial
tissue is common in this age group. The endometrial tissue is the lining of the uterus.
If your symptoms are severe, your doctor
suspects a serious medical problem, or you are considering a certain treatment,
you may also have one or more other tests, such as:
- Blood tests, which may include:
- Pap smear and cultures to check for
infection or abnormal cervical cells.
- Urine test to
screen for infection, disease, and other signs of poor health.
- Transvaginal pelvic ultrasound, to check for any
abnormalities in the pelvic area. After the pelvic exam, a transvaginal
ultrasound is often the next step in diagnosing a vaginal bleeding problem. If
a pelvic mass is found, ultrasound results are useful for making further
testing and treatment decisions.
- Sonohysterogram, which uses
ultrasound to monitor the movement of a salt solution (saline), which is
injected into the uterus. This test may be done to look for uterine
- Endometrial biopsy, usually for women older than 35 or
postmenopausal, to learn whether the
lining of the uterus (endometrium) is healthy and
- Hysteroscopy, if no cause is apparent
but a problem condition is suspected; to check for and treat a suspected
condition, such as uterine fibroids; or if bleeding continues despite
Endometrial cancer risk increases with
age. Also known as uterine cancer, it is most common in women over age 50,
menopause. But endometrial cancer can also
develop earlier, during perimenopause or in women who have had abnormal
bleeding for many years.
- If you have heavy or unusual vaginal bleeding
after menopause, your doctor will do tests, usually either ultrasound or
endometrial biopsy, to look for cancerous cell changes.
- If you are
perimenopausal, have not responded to other treatment for uterine bleeding, or
have things that increase your risk for endometrial cancer, your doctor may recommend an