| History of the Vaginal Bleeding |
- Frequency and duration
- Volume is difficult to quantify but the presence of clots and/or the need to change tampons/pads more often than every 3 hours suggests HMB1,17
- Impact on activities and quality of life8
|
| Gynaecological and Obstetric History |
- Date of the first day of the last menstrual period (LMP)
- History of her typical menstrual cycle
- Pregnancies/miscarriages/stillbirths/terminations
- Gynaecological procedures/surgeries
- Sexually transmitted infections
- Smear tests and results
|
| Bleeding History |
- Spontaneous bruising or bleeding from mucous membranes
- Significant bleeding after previous delivery, tooth extraction, surgery
- Family history
|
| Associated Symptoms |
- Abdominal/pelvic pain/pressure
- Symptoms of anaemia e.g. dyspnoea, fatigue
- Symptoms of infection e.g. fever, dysuria, malodorous/abnormal discharge
- Symptoms of systemic endocrine disorder e.g. Hirsutism in PCOS
|
| Other Key Points |
- Relevant medical/surgical history particularly thyroid, renal and liver disease22
- Current and recent medications. Ask specifically about implanted or intrauterine devices.
- Recent major stress, weight gain/loss, excessive exercise or eating disorder
|
