DIAGNOSIS CHECKLIST
for Menstrual irregularities

Why: i.e. how many days do you bleed for?

Why: i.e. from Day 1 of menstruation to the onset of the next period. "Metrorrhagia" is menstrual bleeding that is irregular in quantity, acyclical in nature and often prolonged in nature. The condition is usually due to a pathological condition in the uterus or other internal genital organs. It's presence demands that the doctor investigate further.

Why: i.e. from day 1 of menstruation to the onset of the next menstrual period. Average interval is 28 days.

Why: e.g. low levels of estrogen, as found around the time of puberty may be associated with irregular bleeding.

Why: some medical conditions can present with abnormal menstrual bleeding e.g. hypothyroidism, iron deficiency anemia, lupus erythematosus, cirrhosis of the liver, leukemia, lymphoma, Acromegaly, cystic fibrosis.

Why: e.g. Depo - Provera contraceptive (intramuscular injection of progesterone) may cause irregular menstrual bleeding; irregular bleeding is common during the first few months of starting a contraceptive pill, but nearly always disappears by 3 to 6 months; the risk of irregular bleeding with the oral contraceptive pill is increased if pills are missed; about 25% of regularly menstruating women give the progesterone-only contraceptive pill develop break through bleeding (irregular bleeding); if peri-menopausal women are given continuous (rather than cyclical) hormone replacement therapy they may develop irregular bleeding.

Why: cigarette smokers are five times more likely to have abnormal periods.

Why: alcoholism may cause heavy menstrual flow and other menstrual disorders.

Why: e.g. marijuana is associated with irregular menstruation.

Why: e.g. fibroids, endometriosis, thyroid disorders, bleeding disorders.

Why: e.g. size of little finger nail, thumb nail, 20 cent coin, 50 cent coin, apricot. Do you get "flooding" i.e. gushing of blood from the vagina when you stand up? See also heavy_periods.

Why: should consider pelvic inflammatory disease, endometriosis, ectopic pregnancy. See also menstrual_cramps or dysmenorrhea.

Why: usually indicate cervical "erosion", cervical polyp, presence of an IUCD and the oral contraceptive pill. Cervical cancer and intrauterine cancer must however be ruled out. See also bleeding_between_periods.

Why: i.e. post-coital bleeding? - usually indicate cervical "erosion", cervical polyp, presence of an IUCD and the oral contraceptive pill. Cervical cancer and intrauterine cancer must however be ruled out. See also bleeding_after_sex.

Why: if pain is deep may suggest endometriosis, pelvic inflammatory disease.

Why: may suggest pelvic inflammatory disease especially if abnormal offensive pus-like vaginal discharge.

Why: e.g. Menstrual pain that begins after years of pain free menstrual periods, pain with intercourse, non-specific pelvic pain, rectal pain especially before and during menstruation, heavy menstrual periods, irregular menstrual bleeding, reduced fertility or infertility.

Why: e.g. lower abdominal pain with or without a fever, pain with sexual intercourse, painful heavy or irregular periods, bleeding between the periods, abnormal perhaps offensive pus-like discharge from the vagina, painful or frequent urination.

Why: e.g. missed periods, nausea, breast tenderness, urinary frequency - may suggest ectopic pregnancy or miscarriage.

Why: e.g. history of a missed period, lower unilateral abdominal pain, abnormal vaginal bleeding, may have signs of pregnancy such as enlarged tender breasts.