Transcript Exams and tests for vaginal bleeding

Exams and tests for
vaginal bleeding
1.Your health care provider will take a
careful medical history. You will be asked
questions about the following issues and
other general questions regarding your
health:
oThis episode of vaginal bleeding
oYour last known normal menstrual cycle
oPrevious episodes of abnormal bleeding
oCurrently pregnant
oPrevious pregnancies
oOutcomes of previous pregnancies
oPresent sexual activity
oNumber of sexual partners
oUse of any form of birth control
oAny medications, over-the-counter, or
illicit drugs you are taking
2.The doctor will also perform a complete
physical, including a thorough pelvic
exam.
A woman who has irregular menstrual periods
requires a physical examination with a special
emphasis on the thyroid, breast, and pelvic area.
oThe exam includes careful inspection of your
external genitalia, urethra, anal area, the vaginal
walls and cervix or birth canal.
They are inspected for the presence of any
lesions or retained foreign objects. Sometimes
a tampon or other object is left in the vagina
and can cause bleeding. The physician attempts
to detect cervical polyps or any unusual masses.
oWhile the doctor is examining your vagina
and cervix, the doctor may take cultures
(fluid samples)from the vagina to test for the
diseases such as gonorrhea and chlamydia.
oThe doctor may also take cells from the cervix
that will be examined for the cervical cancer.
This is a Pap smear.
o It is also important for the doctor to place his
or her hand into your vagina and sometimes
your rectum to detect the shape of your uterus
and ovaries as well as to feel for any masses
that may be present.
3.Tests that may be performed with
abnormal vaginal bleeding.
(1)A pregnancy test needs to be done to make
sure that pregnancy is not the cause of
bleeding.
(2)A blood count will be taken to see if you
are anemic or have a low platelet count.
(3) A clotting series that includes a prothrombin
time (PT) and an activated partial
thromboplastin time (APTT) gives information
about your ability to form clots in your body
to stop bleeding. Abnormal vaginal bleeding
may be the first sign that you may have of a
bleeding disorder.
(4)Sometimes, a blood sample will be tested
for thyroid function, liver function, or kidney
function abnormalities.
(5) The vaginascopy and hysteroscopy. They
are very directly.
(6) A blood hormone test for progesterone levels
or daily body temperature charting may be
recommended to verify that the woman ovulates.
If the doctor suspects that the ovaries are failing,
such as with menopause, blood levels of
follicle-stimulating hormone (FSH) may be
tested.
Additional blood hormone tests are
done if the doctor suspects PCOS or if excessive
hair growth is present.
(7) An ultrasound of the abdomen and pelvis
may be ordered if the doctor may have felt
a mass during the examination.
(8) If a woman does not adequately respond to
medical treatment, if she is over age 40, or if
she has persistent bleeding between her periods,
a sampling of the lining of her uterus
(endometrial biopsy) is analyzed.
An endometrial biopsy may be performed to
take tissue from your uterus. This is performed
in the doctor’s office and is a little more invasive
than a Pap smear. Endometrial sampling helps
to rule out cancer or precancer in the uterus,
or it can confirm a suspicion that a woman is
not ovulating.
First: get the history carefully.
Second: do the physical examination.
Third: choose the necessary tests.
Thank you!