title: Diagnosis of heavy menstrual bleeding.
abstract: Heavy menstrual bleeding (HMB) is an important health problem. This paper gives an overview of the diagnosis of HMB. For each woman, a thorough history should be taken as one should ascertain whether there are underlying factors that could cause complaints of HMB. Objectively knowing whether or not the blood loss is excessive could also be very beneficial. The pictorial blood assessment chart score can help with diagnosis. Physical examination starts with standard gynecological examination. Imaging tests are widely used in the work-up for women with HMB. The first step in imaging tests should be the transvaginal ultrasound. Other diagnostic tests should only be performed when indicated.
authors.affiliation: Department of Obstetrics & Gynecology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Malou C
authors.initials: MC
authors.lastname: Herman
authors.affiliation: The Robinson Institute, School of Paediatrics & Reproductive Health, University of Adelaide, Australia.
authors.forename: Ben W
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Obstetrics & Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: Marlies Y
authors.initials: MY
authors.lastname: Bongers
mesh_terms: D001780:Blood Coagulation Tests; D005260:Female; D006176:Gynecology / Q000592:standards*; D006801:Humans; D008487:Medical History Taking / Q000592:standards; D008595:Menorrhagia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D014463:Ultrasonography
keywords: abnormal uterine bleeding; adenomyosis; diagnosis; fibroid; heavy menstrual bleeding; hysteroscopy; intracavitary pathology; menorraghia; pictorial blood assessment score; polyp