What tests should be done for incomplete menstrual bleeding

Incomplete menstrual bleeding usually requires gynecological ultrasound, six hormone tests, coagulation function, thyroid function, and hysteroscopy examination. In medical terms, menstrual bleeding often refers to a normal menstrual cycle with an extension of more than 7 days, or irregular vaginal bleeding during non menstrual periods, which may be related to factors such as endocrine disorders, uterine lesions, or coagulation abnormalities.

1. Gynecological ultrasound:

Gynecological ultrasound is the preferred examination for screening uterine structural abnormalities, which can observe the thickness of the endometrium, the presence of uterine fibroids, endometrial polyps, ovarian cysts, and other lesions. For example, endometrial polyps or submucosal fibroids often lead to prolonged menstrual periods and incomplete bleeding, and ultrasound examination can clearly display the location and size of these occupying lesions. If the ultrasound indicates uneven thickening of the endometrium, the doctor may recommend further hysteroscopy examination.

2. Six items of sex hormones:

The six items of sex hormones mainly evaluate ovarian function and endocrine status, including follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, and prolactin. When the corpus luteum function is insufficient, progesterone secretion decreases and the endometrium cannot stably shed, leading to prolonged menstruation or bleeding. In addition, patients with polycystic ovary syndrome are prone to menstrual cycle disorders and incomplete discharge due to elevated androgen levels and ovulation disorders.

3. Coagulation function:

Coagulation function tests include indicators such as prothrombin time, activated partial thromboplastin time, fibrinogen, etc., used to rule out coagulation disorders. If patients have thrombocytopenia or vascular hemophilia and other coagulation abnormalities, the endometrial blood vessels cannot clot normally during menstruation, leading to continuous flow of menstrual blood, manifested as incomplete bleeding. These patients may also present with symptoms such as gum bleeding and skin bruising.

4. Thyroid function:

Thyroid function tests include indicators such as thyroid stimulating hormone, free triiodothyronine, and free thyroxine. When hypothyroidism occurs, insufficient secretion of thyroid hormones can affect the regulatory function of the hypothalamic pituitary ovarian axis, leading to ovulation disorders and menstrual abnormalities, resulting in prolonged or increased menstrual periods. hyperthyroidism may also interfere with the menstrual cycle due to accelerated metabolism, causing irregular bleeding.

5. Hysteroscopy:

Hysteroscopy is the gold standard for diagnosing intrauterine lesions, which can directly observe the morphology of the endometrium, the presence of polyps, submucosal fibroids, or endometrial hyperplasia. For cases where ultrasound examination reveals endometrial abnormalities but the nature is unclear, hysteroscopy can take biopsy and send it for pathological examination under direct vision to determine whether there are serious lesions such as endometrial hyperplasia or endometrial cancer. This examination is usually performed 3-7 days after the end of menstruation, and local anesthesia or intravenous anesthesia is required during the procedure.

It is recommended to complete the above examination within 3-7 days after menstruation, and avoid sexual intercourse and vaginal medication before the examination. Pay attention to keeping the perineum clean and dry in daily life, use breathable hygiene products, and avoid vigorous exercise and heavy physical labor. Iron rich foods such as lean beef, pork liver, and spinach can be appropriately increased in diet to prevent iron deficiency anemia caused by long-term bleeding. If the symptoms of incomplete dripping persist for more than two weeks or are accompanied by abdominal pain and fever, seek medical attention promptly.