Lab tests
Lab tests confirm or rule out pregnancy, measure the effect of bleeding on your blood, and look for hormonal or clotting causes. We order them at a lab near you.
| Test | Why it is done | Who needs it |
|---|---|---|
| Pregnancy test (hCG) | Pregnancy and its complications cause bleeding and change the workup | Anyone who could be pregnant |
| Complete blood count | Checks for anemia and low platelets | Nearly everyone with heavy bleeding |
| Ferritin | Measures iron stores; can be low even when hemoglobin is normal | Heavy or prolonged bleeding |
| Thyroid-stimulating hormone (TSH) | Thyroid disease disrupts ovulation | Irregular or heavy bleeding |
| Prolactin | High levels stop ovulation | Irregular or absent periods |
| Testosterone and related tests | Supports a diagnosis of PCOS | Irregular cycles with acne or excess hair growth |
| Chlamydia and gonorrhea | Cervical infection causes spotting | Bleeding between periods or after sex |
| Clotting tests and von Willebrand panel | Screens for bleeding disorders | Heavy bleeding since first period, or other bleeding symptoms |
Your physician chooses tests based on your history. You will not need all of them. We also check that your cervical screening (Pap and HPV testing) is up to date.
Sources
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197–206 (reaffirmed).
- American College of Obstetricians and Gynecologists. Committee Opinion No. 785: Screening and management of bleeding disorders in adolescents with heavy menstrual bleeding. Obstet Gynecol. 2019;134(3):e71–e83.