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Abnormal uterine bleeding is an irregular menstrual cycle that often occurs in women of reproductive age. The diagnosis of abnormal uterine bleeding is important in assessing the bleeding pattern and severity, thereby providing specific management.
1. How is abnormal uterine bleeding diagnosed?
To diagnose abnormal uterine bleeding, the doctor needs to take both the history, physical examination and laboratory tests to give accurate results. The steps to diagnose abnormal uterine bleeding are as follows:
Take the history:
Patient: age, family status, maternity status (PARA) Characteristics of bleeding include: volume, cycle, frequency Last menstrual period and related symptoms Characteristics of the patient's menstrual cycle Personal history: is there any medical, surgical or hormonal treatment? Obstetric history: postpartum functional uterine bleeding, ectopic pregnancy Current method of contraception Family history: has anyone had endometrial cancer? Clinical examination:
General examination for problems: anemia, blood pressure disease, thyroid disease, cardiopulmonary disease Abdominal examination: to detect tumors, ascites, pregnancy On-site examination: vaginal , negative uterus, cervix, uterus, 2 appendages, pelvis (manual and speculum examination)
Khám lâm sàng âm đạo bằng tay
Locate bleeding: cervix, vagina, vulva, perineum, ureter, anus Identify abnormalities in the genital tract: tumor, laceration, foreign body, ulcer,. .. Identify abnormalities in the uterus such as enlarged uterus (uterine fibroids, endometriosis, uterine malignancies), poor adhesion of uterus (endometriosis), uterus Enlarged and painful (internal endometriosis) Subclinical: some commonly used laboratory methods to check are:
Rapid pregnancy test or quantitative β-hCG to rule out the condition pregnant. Complete blood count to assess blood loss. Evaluation of thyroid function: performed only in patients with suspected thyroid abnormalities. Prolactin quantification: only performed when patients report bleeding without ovulation, amenorrhea, lactation or taking drugs to induce lactation. Test for FSH and LH secreted by the pituitary gland: when premature ovarian failure is suspected, hypothalamic dysfunction. Coagulation function test because this is a common cause in women of reproductive age. Uterine pump ultrasound: a liquid is inserted into the uterus through a small tube, from which ultrasound waves will be used to reconstruct the uterus. Basic ultrasound: is a method to record images of the pelvic organs through sound waves. Nuclear magnetic resonance imaging: uses a strong magnetic field to reconstruct images of internal organs. Hysteroscopy: endoscopic hysteroscopy with an instrument through the vagina, through the cervix, and into the uterine cavity. Endometrial biopsy: is a method of taking a sample of cells from the endometrium through a small tube and examining it under a microscope.
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2. Treatments for abnormal uterine bleeding
The choice of method to treat abnormal uterine bleeding depends on factors such as the cause of the bleeding, the age of the patient and the need for pregnancy. Most cases can be treated with medication, but there are times when surgery is required.
Medical treatment:
Medical treatment to control uterine bleeding is usually hormonal drugs. Medications for each patient may vary depending on the patient's age and maternity needs. Birth control pills can help make your periods more regular. Hormonal medications can be given as injections, creams, or through an intrauterine device. Hormones in an IUD that are placed in a woman are released slowly to help control abnormal uterine bleeding. In addition, there are other drugs used to treat abnormal uterine bleeding such as NSAIDs, tranexam acid, antibiotics. Non-steroidal anti-inflammatory drugs can help control bleeding and relieve menstrual pain while tranexam acid is used in patients with hypermenorrhea.
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Surgical methods to treat abnormal uterine bleeding:
Some pathologies such as uterine fibroids, uterine polyps, require surgery to treat. Laparoscopic treatment of abnormal uterine bleeding used in uterine fibroids to remove the tumor. Endometrial ablation is also an option for treating bleeding that can permanently reduce or stop bleeding, but endometrial biopsy is required before ablation is decided. A hysterectomy is a last resort when other methods have failed, it is a major surgery after which a woman no longer has periods and loses the ability to have children. If you have gynecological problems, you can go to Vinmec International General Hospital for examination and treatment. The team of gynecological specialists at Vinmec are well-trained, professional and experienced; system of modern equipment, meeting international standards; Professional service quality, high efficiency in diagnosis and treatment.
For detailed advice, please come directly to Vinmec health system or register online HERE.
