A. Differential Diagnosis
- Dysfunctional Uterine Bleeding: Non-pregnant versus Pregnant
- Infection - especially endometritis, PID
- Neoplasm
- Endometriosis - often painful, nearly always cyclical
- Uterine Fibroids - usually painful
- Uterine Hyperplasia / Polyps
B. Summary Evaluation
- History - menstrual, Family History, dyspareunia, UTI
- Physical - especially rash, masses
- Pelvic Exam with culture for Infectious Diseases
- Gonococci
- Chlamydia
- PAP smear for human papilomavirus (HPV) evaluation
- Herpes simplex virus (HSV)
- CBC, Electrolytes, PT/PTT, ESR (PID), urinalysis
- UCG, quantitative HCG
- Ultrasound