Complete medical history
Evaluation begins with a complete review of your medical history and symptoms. Your nurse and your doctor will get detailed information from you. Depending on what symptoms are present, a physical exam may be needed to complete the evaluation.
Depending on symptoms, a transvaginal ultrasound, where the ultrasound probe is placed inside the vagina, may be done. This test helps to identify what is contributing to bleeding symptoms (such as fibroids, polyps, or a thickened lining of the uterus). We use this technology to evaluate the uterus and ovaries using ultrasound.
Diagnostic office hysteroscopy
A hysteroscopy is a minimally invasive procedure that uses a hysteroscope, or small camera, to look directly inside the uterus. Using advanced technology, we are able to perform this procedure in the office with minimal to no discomfort. A speculum is placed in the vagina in order to see the cervix (the opening to the uterus). The doctor guides a small camera (about the size of the tip of a pen) through the cervix and into the uterus while looking on a monitor.
Using this technique, the doctor can directly see and evaluate the endometrial cavity (the lining and inside of your uterus) in order to identify any abnormalities that could be causing your symptoms. Taking ibuprofen before the procedure can reduce any cramping with this procedure.
Depending on your age and bleeding symptoms, the doctor may perform an endometrial biopsy. An endometrial biopsy is a way of taking a sampling of the lining of the uterus (the endometrium). The sample is sent to a pathologist who examines it microscopically to make sure there are no pre-cancerous or cancerous cells. Sometimes the doctor may recommend blood work, or other imaging studies (such as an MRI or CT Scan).