source not yet started her monthly periods, and she: Has gone through other normal changes that occur during puberty Is older than Such bleeding may be called "intermenstrual bleeding." />

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Old pussy menstrual period exam

Postmenopausal bleeding is an episode of bleeding 12 months or more after the last menstrual period. All women with postmenopausal bleeding should be referred urgently. The peak incidence for endometrial carcinoma is between 65 and 75 years of age. The aim of assessment and investigation of postmenopausal bleeding is to identify a cause and exclude cancer. Assessment should start by taking a detailed history, with identification of risk factors for endometrial cancer, as well as a medication history covering use of HRT, tamoxifen and anticoagulants. Abdominal and pelvic examinations should be carried out to look for masses. Speculum examination should be performed to see if a source of bleeding can be identified, assess atrophic changes in the vagina and look for evidence of cervical malignancy or polyps. Ultrasound scan and endometrial biopsy are complementary. Ultrasound scan can define endometrial thickness and identify structural abnormalities of the uterus, endometrium and ovaries. Endometrial biopsy provides a histological diagnosis.
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Abnormal vaginal bleeding occurs between menstrual periods, after sex, or after menopause.
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Seeing a GP

Back to Heavy periods. See a GP if you feel your periods are unusually heavy or have become heavier. They'll investigate the problem and may offer treatments to help. Your GP may also want to know what type of contraception you're currently using, whether you plan to have a baby in the future and the last time you had a cervical screening test. You'll also be asked about your family history to rule out inherited conditions that may be causing your heavy bleeding, such as Von Willebrand disease , which runs in families and affects blood clotting. A full blood test should be offered to all women with heavy periods. This can identify iron deficiency anaemia , which is often caused by heavy periods. If you have iron deficiency anaemia, you'll usually be prescribed iron tablets. Before carrying out a pelvic examination, your doctor will explain the procedure to you and why it's necessary. You should ask about anything you're unsure about.

Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.

Most girls begin their periods between ages 9 and The average is around 12 years old. If no periods have occurred when a girl is older than 15, further testing may be needed. The need is more urgent if she has gone through other normal changes that occur during puberty. Being born with incompletely formed genital or pelvic organs can lead to a lack of menstrual periods. Some of these defects include:. The health care provider will perform a physical exam to check for birth defects of the vagina or uterus. Treatment depends on the cause of the missing period. Lack of periods that is caused by birth defects may require hormone medicines, surgery, or both. If the problem is caused by a systemic disease, treatment of the disease may allow menstruation to begin.

Abnormal vaginal bleeding occurs between menstrual periods, after sex, or after menopause. Menstrual periods that are heavier or last longer than usual or last more than seven days also are considered abnormal. Your doctor will likely perform a physical and pelvic exam and may test your blood, hormone levels and thyroid function to determine if you are pregnant or infected with a sexually transmitted disease.

Imaging tests such as pelvic ultrasound, transvaginal ultrasound, ultrasound of the uterus, pelvic MRI, hysteroscopy or endometrial biopsy also may be used to help diagnose your condition. Treatment depends on the underlying cause and may include medication, uterine fibroid emobolization, endometrial ablation or surgical intervention.

Normal vaginal bleeding, or menstruation also called a period , is part of a woman's menstrual cycle. It typically occurs every 21 to 35 days and lasts from two to seven days. Abnormal vaginal bleeding is bleeding from the vagina that occurs:.

Abnormal vaginal bleeding has various causes, including fibroids , endometrial polyps , an infection of the uterus, pregnancy, miscarriage, ectopic pregnancy , retained products of conception following pregnancy, or cancers of the uterus including endometrial and cervical cancers. To determine the cause of abnormal bleeding, your physician will perform a physical exam, including a pelvic exam, and may perform one or more of the following:. Please type your comment or suggestion into the text box below.

Note: we are unable to answer specific questions or offer individual medical advice or opinions. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. This website does not provide cost information.

The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America RSNA and the American College of Radiology ACR , comprising physicians with expertise in several radiologic areas. Outside links: For the convenience of our users, RadiologyInfo.

Toggle navigation. What is abnormal vaginal bleeding? How is abnormal vaginal bleeding evaluated? How is abnormal vaginal bleeding treated? Abnormal vaginal bleeding is bleeding from the vagina that occurs: between periods including spotting after sex during menstruation, but is heavier than usual or that lasts longer than usual, or more than seven days after menopause.

To determine the cause of abnormal bleeding, your physician will perform a physical exam, including a pelvic exam, and may perform one or more of the following: blood tests, including a blood clotting profile hormone tests tests for sexually transmitted diseases a pregnancy test thyroid function tests Ultrasound of the pelvis to evaluate the uterus , cervix , ovaries , fallopian tubes and bladder. See the Ultrasound Imaging of the Pelvis page for more information.

A transvaginal ultrasound, in which a small hand-held device is inserted into the vagina, produces pictures of the endometrium , or the lining of the uterine cavity, and the walls of the uterus, called the myometrium , as well as the ovaries. Sonohysterography , or ultrasound of the uterus, provides a more in-depth evaluation of the uterine cavity.

In this minimally invasive procedure, a saline solution is injected into the uterine cavity to help visualize and measure the endometrium and to look for polyps or a mass of tissue.

This exam may also involve an injection of air to help determine if the fallopian tubes are open. Pelvic MRI is used after ultrasound to better visualize fibroids, cancer, or retained products of conception. Hysteroscopy involves inserting into the uterus a narrow lighted tube with an optical instrument or viewing device on the end to allow the physician to look for fibroids , polyps or other abnormalities.

Endometrial biopsy is used to remove and examine a small sample of tissue from the endometrium under a microscope to diagnose cancer or other causes of abnormal bleeding. The procedure, which may be performed as an office procedure alone or in conjunction with hysteroscopy , involves a suction or cutting device that removes a small piece of tissue from the uterus.

Treatment for abnormal vaginal bleeding depends on the underlying cause, and may include: medication birth control pills or hormone-releasing intrauterine devices. Uterine fibroid embolization UFE. In this minimally invasive procedure guided by an x-ray camera called a fluoroscope, tiny particles are injected through a catheter into uterine arteries that are delivering blood to fibroids, blocking blood flow and causing the fibroids to shrink. Endometrial ablation.

Guided by a narrow lighted tube with a viewing device on the end called a hysteroscope , the lining of the uterus is destroyed using a laser or other specialized instruments that produce heat, freezing, microwave energy or electrical currents. Myomectomy , the surgical removal of fibroids.

A procedure in which endometrial tissue is gently scraped or suctioned from the uterus. A surgical procedure in which the uterus is removed. Send us your feedback Did you find the information you were looking for?

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