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. 2016 Jan;12(1):15-20.
doi: 10.2217/whe.15.90. Epub 2015 Dec 23.

Diagnosis of heavy menstrual bleeding

Malou C Herman  1 , Ben W Mol  2 , Marlies Y Bongers  3
Affiliations

Diagnosis of heavy menstrual bleeding

Malou C Herman et al. Womens Health (Lond). 2016 Jan.

Abstract

Heavy menstrual bleeding (HMB) is an important health problem. This paper gives an overview of the diagnosis of HMB. For each woman, a thorough history should be taken as one should ascertain whether there are underlying factors that could cause complaints of HMB. Objectively knowing whether or not the blood loss is excessive could also be very beneficial. The pictorial blood assessment chart score can help with diagnosis. Physical examination starts with standard gynecological examination. Imaging tests are widely used in the work-up for women with HMB. The first step in imaging tests should be the transvaginal ultrasound. Other diagnostic tests should only be performed when indicated.

Keywords: abnormal uterine bleeding; adenomyosis; diagnosis; fibroid; heavy menstrual bleeding; hysteroscopy; intracavitary pathology; menorraghia; pictorial blood assessment score; polyp.

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Figures

Figure 1.
Figure 1.
Flowchart for the investigation of heavy menstrual bleeding. GIS: Gel infusion sonography; HMB: Heavy menstrual bleeding; PBAC: Pictorial blood assessment chart; SIS: Saline infusion sonography.
See this image and copyright information in PMC

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