History

The first thing that we do is to take a detailed and thorough medical history to assess as accurately as possible the nature and extent of the problem.

Examination

We will give you an internal examination if you have not had one from your GP.  A cervical smear is taken if indicated.

Investigation

You will have a blood test to check for anaemia (full blood count) and you may need to be checked for an underactive thyroid (thyroid function tests) as this may sometimes present with bleeding problems. A hormone profile may be required. This is a blood test that may be taken when you are bleeding, or late in the menstrual cycle.





Vaginal Ultrasound



This is a method of looking at your womb and ovaries using sound waves. During the scan the size and lining of the womb and the ovaries are checked. This investigation can tell us if there is any enlargement or disturbance of the lining of your womb (the source of your bleeding).


Sonohysterography



Sometimes during the ultrasound scan there could be a need to visualise the lining of the womb more clearly. This is achieved by inserting a very fine catheter through the neck of the womb and the instillation of a small amount of fluid into the uterus whilst having the internal scan. This procedure will allow better images of the lining of the womb to be obtained and a more accurate diagnosis of the problem. It is a well-tolerated procedure that can be performed in the clinic during the same consultation.

Endometrial biopsy

We may need to check a small sample of the womb lining (the endometrium). A narrow tube is put through the cervix and a specimen is sucked through the tube. This procedure can be slightly uncomfortable but has got the advantage that it does not involve a stay in hospital, a general anaesthetic or opening of the cervix. 


Hysteroscopy

In some cases we will need to perform a hysteroscopy. This is a very simple procedure which takes about 10 minutes and which we can occasional perform without anaesthetic. It involves the insertion of a very small telescope through the cervix to directly visualise the internal lining of the womb. This telescope has a small video camera attached, which allows the enlarged picture from the telescope to be seen on a television screen. In this way, the lining of the womb can be inspected to identify anything that might be causing your problem (e.g. a polyp).

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