Abnormal Bleeding Evaluation

How we identify heavy or unusual periods and what causes them

During your evaluation, your nurse and doctor will get a complete medical history from you, which includes detailed information about your medical history and symptoms. The next step often is a physical exam.

Center for Minimally Invasive Gynecologic Surgery (MIGS), Newton-Wellesley Hospital
2014 Washington Street
Newton, MA 02462
Phone: 617-243-5205
Fax: 617-243-6922

Complete History:

The nurse and doctor get detailed information about medical history and symptoms.

Physical Exam for Abnormal Bleeding

Depending on your symptoms, you might need a physical exam for us to determine the cause and extent of your abnormal bleeding. This exam includes several tests.

Office Ultrasound

Our doctors at the Center for Minimally Invasive Gynecologic Surgery perform their own ultrasounds. We’ll evaluate your uterus and ovaries during your ultrasound. Depending on your symptoms, you might need a transvaginal ultrasound, in which the doctor inserts an ultrasound probe into the vagina. This can help us identify what’s contributing to your bleeding, such as:

• Fibroids
• Polyps
• Thickened uterine lining

The Center for Minimally Invasive Gynecologic Surgery also offers 3D ultrasound, which allows for better visualization and evaluation of the uterus in some cases.

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. Your doctor will place a speculum in the vagina in order to see the cervix (or 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.

Depending on the timing in the menstrual cycle and what symptoms are present, a diagnostic office hysteroscopy may be performed at the initial visit. Taking ibuprofen before the procedure can reduce the cramping with this procedure.

Endometrial Biopsy:

Depending on age and bleeding symptoms, your doctor may perform an endometrial biopsy. An endometrial biopsy is a way of taking a sampling of the lining of the uterus (the endometrium). This is sent to a pathologist who examines it microscopically to make sure there are no pre-cancerous or cancerous cells.

Other Testing:

Sometimes your doctor may recommend blood work or other imaging studies (such as an MRI or CT scan).

At the Center for Minimally Invasive Gynecologic Surgery, much of the evaluation, such as ultrasounds and office hysteroscopy, can be completed during the initial visit. By completing many of the necessary steps at one visit, the doctor will have most, if not all, of the information needed to discuss the different management and treatment options.