How To Diagnose and Treat Abnormal Uterine Bleeding

clinical topics gyn tricky cases urgent care Jun 01, 2021

An image of a woman in a pink and dark blue background with a text Diagnostic Approach To Abnormal Uterine Bleeding

It’s easy to think the worst when your patient mentions abnormal bleeding. It can mean so many things! Remember that the context is everything for the patient with abnormal uterine bleeding. Their age, their history, when it started, how long it lasted, their other diagnoses, even their other medications. These are all factors to consider in the patient with abnormal uterine bleeding, and will point you in a starting direction for your assessment and help you to build your differential.

Having a good understanding of what is normal for periods is crucial.

Abnormal uterine bleeding often doesn’t mean the same thing for a young person in their twenties compared to someone who is past menopause. Do you know when people tend to start having periods (menarche)? Do you know when people tend to stop having periods (menopause)? Are you solid on what stopping having periods even means? Once you are solid on what is normal, you will get up to speed with abnormal things much faster.

If you feel unsure about where to start when working with the patient with abnormal uterine bleeding, this week’s episode should help. We will cover the history questions to ask, the labs to order, and the imaging to order - and we will go even deeper. We’ll also talk about:

Normal versus abnormal uterine bleeding
The anatomical factors that are key to your assessment
Potential causes of abnormal uterine bleeding
Other conditions that could cause or contribute to abnormal uterine bleeding
Pearls related to imaging (what to order, and how)

Like so many other concerns in healthcare, abnormal uterine bleeding can be scary, for patients as well as providers. Increasing your knowledge level will increase your comfort level. This will help you to build a strong differential, guide your patients, and address their concerns effectively.