The NICE guidelines states that: "Many women presenting to primary care with symptoms of<unk>  can be offered treatment without the need for further examination or investigation. However, investigation via a diagnostic technique might be warranted for women for whom history or examination suggests a structural or endometrial pathology or for whom the initial treatment has failed." Diagnosis is largely achieved by obtaining a complete medical history followed by physical exam and vaginal ultrasonography. If need be, laboratory tests or hysteroscopy may be used. The following are a list of diagnostic procedures that medical professionals may use to identify the cause of the abnormal uterine bleeding. * Pelvic and rectal examination to ensure that bleeding is not from lower reproductive tract (i.e. vagina, cervix) or rectum * Pap smear to rule out cervical neoplasia * Pelvic ultrasound scan is the first line diagnostic tool for identifying structural abnormalities. * Endometrial biopsy in women with high risk endometrial cancer or atypical hyperplasia or malignancy. * Hysteroscopy (anaesthesia should be offered) * Thyroid-stimulating hormone and thyrotropin-releasing hormone dosage to rule out hypothyroidism
Heavy menstrual bleeding
Irregular menstruation
Intermenstrual bleeding
Abnormal uterine bleeding
Vaginal bleeding
Frequent urination
Abdominal aura
Urethrorrhagia