What tests should be done for irregular menstrual bleeding?

There will be vaginal bleeding after menstruation, and the blood flows out from the uterus. This is a normal physiological phenomenon. However, some women have irregular menstrual bleeding, which may be a serious gynecological disease. Patients can choose treatment according to their condition. Before treatment, the cause and severity of the disease must be determined first, and then a reasonable treatment plan should be formulated. So what examinations should be done for irregular menstrual bleeding? The examination at this time includes multiple items, all of which are routine gynecological examinations.

Medical history

You should inquire in detail about the amount of leucorrhea, whether it stains underwear or requires a menstrual belt; the color of the leucorrhea; whether there is any special odor; the time of occurrence; whether it irritates the vulva and causes itching; whether there has been a diagnosis of pathological leucorrhea in the past; what kind of treatment has been received; whether the spouse suffers from urinary and reproductive system diseases, etc.

Physical examination

The examination is carried out from outside to inside. First, the vulva, urethra, paraurethral glands and Bartholin's glands are inspected visually, and then the vaginal wall and cervix are observed through a vaginal speculum. (A) Visual examination of the vulva can help identify vaginitis. Erythema and small collar fissures around the vulva and anus may be caused by candidiasis, and vulvar edema may be caused by trichomoniasis. The vulva of patients with Trichomonas vaginitis or cervicitis is often contaminated with a large amount of purulent vaginal discharge, while in bacterial vaginosis, only accumulated vaginal discharge is seen at the vaginal opening. (ii) Appearance of vaginal discharge Various pathological vaginal discharges have different specific characteristics that can provide diagnostic clues. 1. Physiological leucorrhea has the following characteristics: homogeneity, flocculence, high efficiency and accumulation in the sagging part of the vagina. 2. Bacterial vaginal discharge is gray, homogeneous, and has low bulging. It is often evenly attached to the surface of the vaginal mucosa on the anterior or lateral wall of the vagina. It is easy to wipe off and there is no obvious change in the vaginal mucosa. 3. The leucorrhea caused by Trichomonas vaginitis is yellow or even yellow-green, obviously purulent, and often foamy. 4. The leucorrhea of ​​candidiasis is white, highly thick, and cheesy or tofu-like, attached to the vaginal wall. Sometimes it resembles white thrush-like patches. There may also be very little leucorrhea or it may be similar to normal leucorrhea, but the vaginal wall appears as white spots. (III) Cervical secretions: The cervix has clear fluid-like secretions before ovulation, which become thicker during the luteal phase. 1. Cervicitis: If there is purulent cervical discharge at any stage of the menstrual cycle, the possibility of cervicitis should be considered. During the examination, the vaginal discharge outside the cervical opening should be wiped clean, and cervicitis can be diagnosed if purulent discharge is observed in the endocervical canal lining. At this time, the columnar surface of the endocervical lining becomes erythematous and more brittle, and wiping with a cotton swab often causes bleeding. 2. Chlamydial cervicitis In chlamydial cervicitis, the columnar epithelium often hypertrophies and proliferates, protruding from the squamous epithelium plane. 3. Malaria-related viral cervicitis often presents ulcerative or necrotic lesions in the columnar epithelium. 4. Gonorrheal cervicitis causes yellow, thick fluid or plugging in the cervical canal, which overflows into the vagina and causes vaginitis. It squeezes the urethra, paraurethral glands or Bartholin's glands, often causing purulent discharge.

Equipment inspection

Observe the leucorrhea under a microscope. Guided by the clues of the appearance of the discharge, it is easier to get a correct diagnosis through microscopic observation. Mix a small amount of vaginal discharge with normal saline on a slide to disperse the vaginal epithelial cells, and observe lactobacilli, white blood cells, Trichomonas and clue cells under a high-power microscope (400x). Use 10% KOH solution to mix a larger amount of leucorrhea on another slide and observe Candida under a 100x microscope.

What tests should be done for irregular menstrual bleeding? There are many things to pay attention to when checking before the end of menstruation. Many types of tests have the chance of being infected with bacteria. It is recommended that patients check after the end of menstruation. If the bleeding is completely abnormal, go to the hospital for examination immediately. A professional doctor will judge the physical condition and stop the bleeding after finding the cause of the irregular bleeding. Of course, normal menstrual blood must be ruled out to prevent the patient from diseases caused by inflammation, various gynecological tumors, cancer, etc.