Dysfunctional Uterine Bleeding

Your doctor must first rule out all Reference other medical causes of vaginal bleeding before diagnosing dysfunctional uterine bleeding (DUB).

First tests

First, your doctor will:

• Review your history of symptoms and menstrual periods. (If possible, bring with you a record of the days you had your period, how heavy or light the flow was, and how you felt each day.)
• Conduct a routine Reference pelvic exam.
• Find out whether you are ovulating regularly. This is done using one or more of the following:
  • A daily record of your symptoms (menstrual calendar)
  • A daily Reference basal body temperature Opens New Window chart, if you have been keeping track at home. This charts your at-rest temperature.
  • A Reference progesterone test, because low levels during the third week of a menstrual cycle suggest an ovulation problem
  • An Reference endometrial biopsy for perimenopausal women, because abnormal endometrial tissue is common in this age group. The endometrial tissue is the lining of the uterus.

Other tests

If your symptoms are severe, your doctor suspects a serious medical problem, or you are considering a certain treatment, you may also have one or more other tests, such as:

• Blood tests, which may include:
  • Reference Pregnancy test (human chorionic gonadotropin, or hCG).
  • Reference Complete blood count (CBC), to check for signs of disease, infection, and anemia.
  • Reference Thyroid-stimulating hormone (TSH) to check for a thyroid gland problem, which can cause menstrual irregularity.
  • Reference Serum prolactin level, to check for a Reference pituitary gland Opens New Window problem, which can interfere with or stop the menstrual cycle.
  • Reference Serum ferritin, to check for anemia, a symptom of heavy blood loss.
• Reference Pap smear Opens New Window and cultures to check for infection or abnormal cervical cells.
• Reference Urine test to screen for infection, disease, and other signs of poor health.
• Reference Transvaginal pelvic ultrasound, to check for any abnormalities in the pelvic area. After the pelvic exam, a transvaginal ultrasound is often the next step in diagnosing a vaginal bleeding problem. If a pelvic mass is found, ultrasound results are useful for making further testing and treatment decisions.
• Sonohysterogram, which uses ultrasound to monitor the movement of a salt solution (saline), which is injected into the uterus. This test may be done to look for uterine Reference polyps Opens New Window or Reference fibroids Opens New Window.
• Reference Endometrial biopsy, usually for women older than 35 or who are Reference postmenopausal Opens New Window, to learn whether the lining of the uterus (endometrium) is healthy and functioning normally.
• Reference Hysteroscopy, if no cause is apparent but a problem condition is suspected; to check for and treat a suspected condition, such as uterine fibroids; or if bleeding continues despite treatment.

Early detection

Reference Endometrial cancer Opens New Window risk increases with age. Also known as uterine cancer, it is most common in women over age 50, after menopause. But endometrial cancer can also develop earlier, during perimenopause or in women who have had abnormal bleeding for many years.

• If you have heavy or unusual vaginal bleeding after menopause, your doctor will do tests, usually either ultrasound or endometrial biopsy, to look for cancerous cell changes.
• If you are perimenopausal, have not responded to other treatment for uterine bleeding, or have things that increase your risk for endometrial cancer, your doctor may recommend an endometrial biopsy.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.