What is included in the physical exam to evaluate 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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Answer

The physical examination can elicit several anatomic and organic causes of abnormal uterine bleeding (AUB).

A complete physical examination should begin with assessment of hemodynamic stability (vital signs) and proceed with evaluation of the following:

  • Obesity (BMI)

  • Signs of androgen excess (hirsutism, acne)

  • Thyroid enlargement or manifestations of hyperthyroidism or hypothyroidism.

  • Galactorrhea (may suggest hyperprolactinemia)

  • Visual field deficits (raise suspicion of intracranial/pituitary lesion)

  • Ecchymosis, purpura (signs of bleeding disorder)

  • Signs of anemia or chronic blood loss

  • A careful gynecologic examination, including Papanicolaou test (Pap smear) and sexually transmitted disease (STD) screening, is warranted.

  • The hallmark of AUB is a negative pelvic examination despite the clinical history. In such cases, management might rest on a clinical diagnosis. Rule out the presence of uterine fibroids or polyps, as well as rule out endometrial hyperplasia or carcinoma.


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