Investigation of problems with menstruation
Table of Contents
History
The doctor will initially want to know details of when your periods started and their subsequent pattern.
He or she will ask questions which will give clues for the presence of a clotting disorder or Thyroid malfunction.
Irregular periods which are caused by hormonal imbalance could be affected by stress, body weight changes, excessive exercise, hyperprolactinaemia.
Physical examination
An internal examination will be performed to exclude gynaecological disorders (i.e fibroids, cervical polyps).
A cervical smear will be taken if one is due.
If a coil is in place another form of contraception may be suggested if you have the coil removed, although this is not always necessary.
Blood tests
A blood sample will be taken to check that you are not anaemic.
If there is a suspicion of hormonal abnormality, hormonal blood tests will be ordered.
Ultrasound scanning
The gynaecologist may suggest ultrasound scanning which provides pictures on a screen of your womb and ovaries. This can be done either abdominally or through a transvaginal probe . Ultrasound will give information on the shape and size of the womb and on possible ovarian swellings. It can also check for the presence of submucosal fibroid or endometrial polyps.
Hysteroscopy & Dilatation and Curettage
If you are over 40, the gynaecologist may also suggest an investigation called a hysteroscopy and curettage to exclude abnormalities in the womb lining.
If this minor operation is performed, a general anaesthetic will be necessary and the operation carried out on a 'day case' basis. On admission to your hospital or day-surgery unit you may be given a pre-medication tablet which will make you feel sleepy, before a general anaesthetic injection in your arm.
When you are in the operating theatre the gynaecologist will re-examine you and then dilate the cervix. Following dilatation a thin telescope, about as wide as a pencil and called a hysteroscope, will be used to inspect the lining. A specimen of the lining will then be taken to send to the laboratory to check that all is well.