What to check for irregular menstruation?

Irregular menstruation usually requires checking six items of sex hormones, gynecological ultrasound, thyroid function, blood routine and coagulation function. Irregular menstruation may be related to factors such as endocrine disorders, uterine lesions, thyroid disease, anemia or coagulation disorders, and requires targeted treatment according to the specific cause.

1. Six items of sex hormones

The six sex hormones include follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone and prolactin. Through venous blood testing, ovarian function and the regulatory status of the hypothalamic-pituitary-ovarian axis can be evaluated. Patients with polycystic ovary syndrome may have an elevated luteinizing hormone to follicle stimulating hormone ratio, and elevated follicle stimulating hormone levels are common in perimenopausal women. You need to fast before the examination and avoid menstrual period.

2. Gynecological ultrasound

Transvaginal or abdominal ultrasound can observe uterine morphology, endometrial thickness and ovarian structure. In patients with uterine fibroids, hypoechoic nodules within the muscle wall can be seen, and endometrial polyps appear as hyperechoic masses in the uterine cavity. Ultrasound can also detect congenital uterine malformations such as septate uterus, or monitor follicle development during ovulation. You need to hold your urine before the examination, and those with no sexual history need to choose rectal ultrasound.

3. Thyroid function

Thyroid function tests include indicators such as thyroid stimulating hormone and free thyroxine. Hyperthyroidism may cause a shortened menstrual cycle, while hypothyroidism often causes increased menstrual flow. Patients with Hashimoto's thyroiditis may be accompanied by positive antithyroid peroxidase antibodies. There is no need to fast before blood collection, but you need to avoid taking biotin-containing health products.

4. Blood routine

Determine whether there is anemia by testing parameters such as hemoglobin and red blood cell count. Long-term menorrhagia may cause iron deficiency anemia, which is manifested by a decrease in the average red blood cell volume. Patients with aplastic anemia develop pancytopenia. Severe anemia can affect the blood supply to the ovaries and aggravate menstrual disorders. Strenuous exercise should be avoided before the examination to prevent false elevation of white blood cell count.

5. Coagulation function

Tests such as prothrombin time and activated partial thromboplastin time can screen for coagulation abnormalities. Menorrhagia may be the first symptom of hemophilia carriers or platelet dysfunction. Vitamin K deficiency can lead to disorders of coagulation factor synthesis. People taking anticoagulant drugs need to inform their doctor in advance to avoid interfering with test results.

It is recommended to record the start and end times of 3 menstrual cycles, menstrual volume and accompanying symptoms before the examination. Avoid sexual intercourse or vaginal douching 24 hours before the examination. If you are diagnosed with polycystic ovary syndrome, you can use ethinyl estradiol and cyproterone tablets as directed by your doctor. Patients with uterine fibroids can consider mifepristone tablets. If you have abnormal thyroid function, you need to take levothyroxine sodium tablets or methimazole tablets. Maintain a regular daily schedule, exercise moderately to control weight, and reduce the intake of high-sugar and high-fat foods.