What is included in the workup of abnormal uterine bleeding (AUB)?

Updated: Dec 07, 2018
  • Author: Millie A Behera, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Laboratory studies

Studies used to exclude a pathologic source of anovulatory bleeding include the following:

  • Human chorionic gonadotropin (HCG)

  • Complete blood count (CBC)

  • Papanicolaou test (Pap smear)

  • Endometrial sampling

  • Thyroid functions and prolactin

  • Liver functions

  • Coagulation studies/factors

  • Other hormone assays, as indicated

Imaging studies

In obese patients with a suboptimal pelvic examination or in patients with suspected ovarian or uterine pathology, pelvic ultrasonographic evaluation may be helpful. Ultrasonography can be used to identify uterine fibroids, as well as endometrial conditions, including hyperplasia, carcinoma, and polyps.


Rule out endometrial carcinoma in all patients at high risk for the condition, including those with the following characteristics:

  • Morbid obesity

  • Diabetes or chronic hypertension

  • Age over 35 years

  • Longstanding, chronic eugonadal anovulation

Traditionally, carcinoma was ruled out by endometrial sampling via dilation and curettage (D&C). However, endometrial sampling in the office via aspiration, curetting, or hysteroscopy has become popular and is also relatively accurate.


Most endometrial biopsy specimens will show proliferative or dyssynchronous endometrium.

See Workup for more detail.

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