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Categories > Menstrual Health > Abnormal bleeding

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How doctors determine the cause of vaginal bleeding

If you experience vaginal bleeding, your doctor will try to determine its cause based on your symptoms, your medical history and a pelvic exam. To rule out uterine cancer, a tissue sample must be taken from inside the uterus. Usually, this is done by endometrial biopsy, which takes only a minute and requires no anesthesia.

Another procedure is dilation and curettage, or D&C, which requires anesthesia. This may be needed if endometrial biopsy doesn’t reveal the cause of bleeding. D&C is also used to diagnose fibroids and to both diagnose and treat uterine polyps.

After dilating (widening) your cervical canal with a series of tapered rods, your surgeon will use an instrument (called a curette) with a sharp, spoon-shaped tip to scrape the lining of your uterus. The tissue that’s collected will be sent to a lab for testing.

Hysteroscopy, which usually can be done in your gynecologist’s office, is yet another diagnostic tool. After a local anesthetic is injected around the cervix, a delicate telescope-like instrument is inserted through the vagina and cervix into the uterus, allowing your doctor a look at the inside of your uterus. The procedure usually takes about a half hour.


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