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CURRENT Medical Diagnosis & Treatment 2013 Abnormal Premenopausal Bleeding Sections: Essentials of Diagnosis, General Considerations, Clinical Findings, Symptoms and Signs, Laboratory Studies, Imaging, Cervical Biopsy and Endometrial Curettage, Hysteroscopy, Treatment, When to Refer, When to Admit. Topics Discussed: anovulation; breakthrough bleeding; gynecology; menorrhagia; myoma; ovulation; uterine hemorrhage; uterine polyp. Excerpt:"The diagnosis usually depends on the following: (1) A careful description of the duration and amount of flow, related pain, and relationship to the last menstrual period (LMP), with the presence of blood clots or the degree of inconvenience caused by the bleeding serving as useful indicators; (2) A history of pertinent illnesses, such as recent systemic infections or hospitalizations, or weight change; (3) A history of medications taken in the past month; (4) A history of coagulation disorders in the patient or family members; (5) A pelvic examination to look for vulvar, vaginal or cervical lesions, pregnancy, uterine myomas, adnexal masses, adenomyosis, or infection...."
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