Health Library

Categories > Menstrual Health > Abnormal bleeding

How doctors determine the cause of vaginal bleeding

If you experience vaginal bleeding, your doctor will try to determine its cause based on your symptoms, your medical history and a pelvic exam. To rule out uterine cancer, a tissue sample must be taken from inside the uterus. Usually, this is done by endometrial biopsy, which takes only a minute and requires no anesthesia.

Another procedure is dilation and curettage, or D&C, which requires anesthesia. This may be needed if endometrial biopsy doesn’t reveal the cause of bleeding. D&C is also used to diagnose fibroids and to both diagnose and treat uterine polyps.

After dilating (widening) your cervical canal with a series of tapered rods, your surgeon will use an instrument (called a curette) with a sharp, spoon-shaped tip to scrape the lining of your uterus. The tissue that’s collected will be sent to a lab for testing.

Hysteroscopy, which usually can be done in your gynecologist’s office, is yet another diagnostic tool. After a local anesthetic is injected around the cervix, a delicate telescope-like instrument is inserted through the vagina and cervix into the uterus, allowing your doctor a look at the inside of your uterus. The procedure usually takes about a half hour.