MENORRHAGIA
Ask the Following Questions:
- Is there persistent or recurring abdominal or pelvic pain? The presence of pain with menorrhagia should make one suspect PID, endometriosis, and ectopic pregnancy.
- Are there abnormalities on the pelvic examination? The pelvic examination will usually be positive in cases of uterine fibroid, pregnancy, cervical polyp, pelvic inflammatory disease, and ectopic pregnancy. Endometriosis may not always be detected on pelvic examination.
- Is there anemia or other systemic symptoms or signs? The clinician should remember that iron deficiency anemia, hypothyroidism, lupus erythematosus, and cirrhosis of the liver are just a few of the systemic conditions that may present with menorrhagia.
DIAGNOSTIC WORKUP
Routine studies include a CBC, sedimentation rate, urinalysis, pregnancy test, chemistry panel, ANA titer, VDRL test, coagulation profile, thyroid profile, and flat plate of the abdomen. A Pap smear and vaginal smear and culture should be done.
If these tests are negative, referral to a gynecologist should be made before undertaking expensive tests such as pelvic ultrasound or CT scan of the abdomen and pelvis. Some clinicians will probably ignore this advice. A gynecologist will often be able to resolve the diagnostic dilemma with a good pelvic examination. Laparoscopy, culdocentesis, endometrial biopsy, and dilation and curettage are just a few of the diagnostic tools at his disposal.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
Other Book Chapters Related to Heavy periods
Read excerpts from these other book chapters related to Heavy periods:
Medical Books Excerpts
- Metrorrhagia
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Menorrhagia
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Menorrhagia
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.
More About Causes of Heavy periods
» Next page: HYPERMENORRHEA (Differential Diagnosis in Primary Care)
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