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A hormone level evaluation would be an appropriate test at this point in order to help ascertain the cause of the excessive bleeding. A gynecological examination may bring the cause to light if a mass is felt. In this case, and often even if no mass is palpated, the patient may be sent for an ultrasound to determine whether there is a mass or whether the lining of the uterus has enlarged too much. At times, the healthcare practitioner may also consider the need for an endometrial biopsy which can aid in determining the cause of the excessive bleeding. The response of the uterus to estrogen is determined in such a study. Normally this would not be done if fibroids or polyps were found initially on ultrasound. In all cases, more serious causes of the bleeding, such as cancer, would be ruled out by testing and examination. This is especially true if bleeding occurs after menopause.
Conventional Medical Treatments
After a diagnosis has been made regarding the cause of the excess bleeding, the recommended course of action depends on the reason for the bleeding and on the size and nature of any structural problems which have been found. Hormonal therapy to correct imbalances in normal hormone regulation is usually the first consideration. If fibroids are found, hormones may be recommended to decrease their size, in the hope that by doing so the bleeding will decrease. If the fibroids are very large or numerous, hormones may be recommended for awhile until surgery can be safely performed to remove the fibroids. In some cases of DUB, a dilation and curettage (D&C) may be recommended. This procedure involves scraping the endometrium of the uterus. Often

 
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