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DIAGNOSIS
To help diagnose menstrual disorders, you should schedule an appointment with your health care professional. To prepare, keep a record of the frequency and duration of your periods. Also jot down any additional symptoms, such as cramping, and be prepared to discuss health history. Here is how your health care professional will help you specifically diagnose abnormal uterine bleeding, dysmenorrhea, PMS and PMDD:
Abnormal uterine bleeding
To diagnose abnormal uterine bleeding (AUB), your health care professional will conduct a full medical examination to see if your condition is related to an underlying medical problem. This could be structural, such as fibroids or endometriosis, or hormonal. The examination involves a series of tests. These may include:
Endometrial biopsy. A gentle scraping method is used to remove some tissue removed from the lining of your uterus. The tissue is analyzed under a microscope to identify any possible problem, including cancer.
Ultrasound. High-frequency sound waves are reflected off pelvic structures to provide an image. Your uterus may be filled with a saline solution to perform this procedure, sonohysterography. No anesthesia is necessary.
Diagnostic hysteroscopy. In this diagnostic procedure, your health care professional looks into your uterine cavity through a miniature telescope-like instrument called a hysteroscope. Either general or local anesthesia is used, and the procedure can be performed in the hospital or in a doctor's office.
You can also expect blood tests to check your blood count and a urine test to see if you're pregnant, as well as other laboratory tests.
The more information you can give your health care professional, the better. Take notes on the dates and length of your periods. You can do this by marking your calendar or appointment book. You might also be asked to keep a daily track record of your temperature to determine when you are ovulating. Ovulation kits are available without a prescription and are easy to use.
During your initial evaluation with your health care professional, you should also discuss the following:
- Current medications
- Details about menstrual flow and cycle length
- Any gynecologic surgery or gynecologic disorders
- Sexual activity and history of sexually transmitted diseases
- Contraceptive use and history
- Family history of fibroids or other conditions associated with AUB
- History of a breast discharge
- Blood clotting disorders
PMS and PMDD
There are no specific diagnostic tests for PMS and PMDD. You'll probably be asked to keep track of your symptoms and write them down. A premenstrual symptom checklist is one of the most common methods currently used to evaluate symptoms. With this tool, you can track the type and severity of symptoms to help identify a pattern.
Generally PMS and PMDD symptoms:
- tend to increase in severity as the menstrual cycle progresses.
- tend to be relieved when menstrual flow begins or soon afterward.
- are present for at least three consecutive menstrual cycles
