ABNORMAL PREMENOPAUSAL VAGINAL BLEEDING GYNAECOLOGICAL CAUSES

Edward A Lyons MD FRCP(C) FACR, Professor of Radiology and Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba

The most common gynecological causes of premenopausal bleeding are adenomyosis, submucous fibroids, polyps, dysfunctional bleeding and less likely, endometrial carcinoma.

Ultrasound is and should be the method of choice in identifying the exact cause of the bleeding. One would always begin the study with a transvesical exam, empty the bladder and proceed to the endovaginal exam. The endovaginal study provides the sonographer and sonologist with a high resolution, magnified view of the uterus, myometrium, endometrial canal and adnexa. In addition, it provides a unique opportunity to “palpate” the pelvic organs and to “visualize” the site of pain or tenderness. This is very helpful in making the diagnosis by correlating the ultrasound and clinical findings. I believe also that a color Doppler study should also be a part of every study. It will help confirm and in some cases identify pathological processes.

There are two major types of abnormal vaginal bleeding, 1) excessively heavy periods or menorrhagia and 2) bleeding between periods or metrorrhagia.

Citation
Lyons E. Abnormal premenopausal vaginal bleeding Gynecological causes. ASUM Bulletin 2002.2:20-22.