How to diagnose menstrual irregularities

Irregular menstruation is a common gynecological disease, manifested as abnormal menstrual cycle or bleeding volume, or abdominal pain and systemic symptoms before and during menstruation. The cause of irregular menstruation may be organic lesions or dysfunction. Many systemic diseases such as blood diseases, hypertension, liver diseases, endocrine diseases, miscarriage, ectopic pregnancy, hydatidiform mole, reproductive tract infection, ovarian tumors, uterine fibroids, etc. can cause irregular menstruation. The diagnosis of irregular menstruation should pay attention to identifying the cause, and pay attention to the following aspects:

Pay attention to asking the patient about past menstrual history, whether there is a history of amenorrhea, reproductive history, history of abortion, history of chronic diseases or medications that affect menstruation, history of gynecological diseases, etc.

Gynecological examination

During the gynecological examination, attention should be paid to any special abnormalities of the internal and external genitalia. If it is polycystic ovary syndrome, the ovaries on both sides are slightly enlarged; if it is endometriosis, one or both ovaries are enlarged, cystic, adhered to the uterus, the uterus is fixed and tilted backward, and nodules can be felt in the isthmus of the uterus.

B-ultrasound examination

Pelvic or vaginal B-ultrasound examinations can rule out diseases such as miscarriage, ectopic pregnancy, endometriosis, polycystic ovary syndrome, and intrauterine adhesions.

Endocrine examination

Endocrine examinations include testosterone, prolactin, follicle-stimulating hormone, luteinizing hormone, etc., which can rule out polycystic ovary syndrome, premature ovarian failure, anovulatory dysfunctional uterine bleeding, etc. Note that hormone drugs should be discontinued before the examination to avoid affecting the blood endocrine report results.