Abnormal Uterine Bleeding: Causes and Diagnostic Tests

Secretion abnormalities

1.
Hello, doctor.
If there is abnormal bleeding from the uterus, can an ultrasound reveal the cause?
2.
I have visited two different hospitals, and both doctors said that my uterus looks fine.
However, I still have a little bit of brown discharge today.
What could be the reason for this?
3.
What tests would you recommend for me to feel more at ease?

Dan, 10~19 year old female. Ask Date: 2017/11/06

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
If there is abnormal bleeding from the uterus, can an ultrasound reveal the cause? Ans: Yes.

2.
I have seen doctors at two different hospitals, and both said my uterus looks fine, yet today I still have a little bit of brown discharge.
What could be the reason? Ans: Hormonal imbalance.

3.
What tests did the doctor recommend for me to feel more at ease? Ans: First, relax, maintain a regular lifestyle, eat a balanced diet, exercise moderately, and take care of your body.

Reply Date: 2017/11/06

More Info

Abnormal uterine bleeding (AUB) is a common concern among women and can arise from various causes, ranging from hormonal imbalances to structural abnormalities in the reproductive system. Understanding the underlying reasons for AUB and the appropriate diagnostic tests is crucial for effective management and treatment.

1. Can ultrasound detect the cause of abnormal uterine bleeding?
Yes, ultrasound is a valuable diagnostic tool in evaluating abnormal uterine bleeding. Transvaginal ultrasound, in particular, is often preferred as it provides a clearer view of the uterus and ovaries. This imaging technique can help identify structural issues such as fibroids, polyps, or abnormalities in the endometrial lining. It can also assess the thickness of the endometrium, which can indicate hormonal imbalances or other conditions. If the ultrasound results are inconclusive, further imaging studies such as hysterosonography or MRI may be recommended.

2. Why is there persistent brown discharge despite normal ultrasound findings?
The presence of brown discharge, especially if it is light and intermittent, can often be attributed to hormonal fluctuations. Even if the ultrasound shows no structural abnormalities, hormonal imbalances can lead to irregular shedding of the endometrial lining, resulting in atypical bleeding patterns. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or perimenopause can contribute to these imbalances. Additionally, stress, weight changes, and lifestyle factors can also play a role in menstrual irregularities. It is essential to monitor the situation and consult with a healthcare provider if the symptoms persist or worsen.

3. What diagnostic tests should be considered for reassurance?
To gain a comprehensive understanding of the underlying causes of abnormal uterine bleeding, several diagnostic tests may be recommended:
- Blood Tests: Hormonal levels, including estrogen, progesterone, thyroid hormones, and prolactin, can be evaluated through blood tests. These tests help identify any hormonal imbalances that may be contributing to AUB.

- Endometrial Biopsy: If there are concerns about the endometrial lining, especially in women over 35 or those with risk factors for endometrial cancer, an endometrial biopsy may be performed. This procedure involves taking a small sample of the endometrial tissue for laboratory analysis.

- Hysteroscopy: This procedure allows direct visualization of the uterine cavity using a thin, lighted tube. It can be used to diagnose and treat conditions such as polyps or fibroids.

- Pap Smear: If not already performed, a Pap smear can help screen for cervical abnormalities, which may also contribute to abnormal bleeding.

In conclusion, abnormal uterine bleeding can stem from various causes, and a thorough evaluation is essential for accurate diagnosis and treatment. If you are experiencing persistent or concerning symptoms, it is crucial to maintain open communication with your healthcare provider, who can guide you through the necessary diagnostic tests and develop an appropriate management plan. Regular follow-ups and monitoring of your symptoms will also help ensure your reproductive health is maintained.

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