Which tests are commonly included in the workup for Dysfunctional Uterine Bleeding?

Which tests are commonly included in the workup for Dysfunctional Uterine Bleeding?

• A. Hormone levels, transvaginal ultrasound; endometrial biopsy if stripe >4 mm or age >35
• B. Urinalysis only
• C. CT abdomen and pelvis
• D. Genetic testing

Answer: (A)

Dysfunctional uterine bleeding is evaluated to find hormonal causes of ovulatory dysfunction and to rule out endometrial pathology. The best workup combines assessing the hormonal milieu, imaging the uterus and endometrium, and sampling the endometrium when risk factors for hyperplasia or cancer are present. Hormone levels help identify endocrine issues that disrupt regular ovulation, such as thyroid or prolactin disturbances, or ovarian dysfunction. A transvaginal ultrasound measures the endometrial stripe and looks for structural issues like fibroids or polyps, guiding further management. Endometrial biopsy is recommended when the endometrial lining is thick enough to raise concern for hyperplasia or cancer—specifically if the endometrial stripe is greater than about 4 mm in postmenopausal bleeding or when a patient is older than 35 with abnormal bleeding. Urinalysis alone, CT imaging, or genetic testing do not address the primary concerns of DUB workup and are not first-line in this context.

Dysfunctional uterine bleeding is evaluated to find hormonal causes of ovulatory dysfunction and to rule out endometrial pathology. The best workup combines assessing the hormonal milieu, imaging the uterus and endometrium, and sampling the endometrium when risk factors for hyperplasia or cancer are present. Hormone levels help identify endocrine issues that disrupt regular ovulation, such as thyroid or prolactin disturbances, or ovarian dysfunction. A transvaginal ultrasound measures the endometrial stripe and looks for structural issues like fibroids or polyps, guiding further management. Endometrial biopsy is recommended when the endometrial lining is thick enough to raise concern for hyperplasia or cancer—specifically if the endometrial stripe is greater than about 4 mm in postmenopausal bleeding or when a patient is older than 35 with abnormal bleeding. Urinalysis alone, CT imaging, or genetic testing do not address the primary concerns of DUB workup and are not first-line in this context.