Vaginal Bleeding (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Vaginal bleeding facts
- What is normal vaginal bleeding?
- What is abnormal vaginal bleeding?
- What conditions cause abnormal vaginal bleeding in women who are ovulating regularly?
- What conditions cause abnormal vaginal bleeding in women who are not ovulating regularly or vaginal bleeding after menopause?
- What causes abnormal vaginal bleeding during or after sexual intercourse?
- What causes abnormal vaginal bleeding during pregnancy?
- What tests are used to evaluate abnormal vaginal bleeding?
- How is irregular or abnormal vaginal bleeding treated?
- Find a local Obstetrician-Gynecologist in your town
What diagnostic tests are used to evaluate abnormal vaginal bleeding?
- A woman who has irregular menstrual periods requires a physical examination with a special emphasis on the thyroid, breast, and pelvic area. During the pelvic examination, the physician attempts to detect cervical polyps or any unusual masses in the uterus or ovaries.
- A Pap smear is also done to rule out cervical cancer. While the Pap smear is being obtained, samples might be taken from the cervix to test for the presence of infections such as chlamydia or gonorrhea.
- A pregnancy test is routine if the woman is premenopausal.
- A blood count may be done to rule out a low blood count (anemia) resulting from excessive blood loss.
- If something in the patient's (or her family's) medical background or physical examination raises a doctor's suspicion, tests to rule out certain blood clotting disorders may be done.
- Sometimes, a blood sample will be tested to evaluate thyroid function, liver function, or kidney function abnormalities.
- A blood 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 polycystic ovary, or if excessive hair growth is present.
- A pelvic ultrasound is often performed based on the woman's medical history and pelvic examination.
- If a woman does not adequately respond to medical treatment, if she is over age 40, or if she has persistent vaginal bleeding between her periods, a sampling of the lining of her uterus (termed endometrial sampling or endometrial biopsy) is often analyzed. Endometrial sampling helps to rule out cancer or precancer in the uterus, or it can confirm a suspicion that a woman is not ovulating.
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