There are blood stains on my underwear when I don't have my period

If you don't have your period but there are blood stains on your underwear, this may be caused by vaginal bleeding. Vaginal bleeding is a health condition that many women suffer from, and it is also a symptom that female patients should pay attention to, because vaginal bleeding may mean that they have some gynecological diseases. After vaginal bleeding, it is best to get checked first. Here we will introduce to you what tests you need to do for vaginal bleeding.

1. Gynecological examination

Conditions of the vulva, vagina, cervix, uterus, and adnexa, etc.

2. Routine blood and urine examination

Patients of childbearing age often require urine or blood HCG testing to rule out pregnancy or pregnancy-related diseases. Depending on the situation, thyroid function, liver function, kidney function, coagulation function and sex hormone tests may also be required.

3. Cervical cytology and HPV testing

Those who have bleeding during sexual intercourse or cervical inflammation, polyps, and bleeding should undergo this examination, which can help diagnose early cervical cancer.

4. Ultrasound examination: B-ultrasound (transabdominal or transvaginal)

Patients with uterine bleeding often need to undergo pelvic B-ultrasound examination to understand the size and shape of the uterus, the thickness of the endometrium, whether there are abnormal echoes in the uterine cavity, whether there are masses in the adnexal area and the characteristics of the masses, whether there is abdominal effusion, etc.

5. Biopsy

① Lesions of the vulva, vagina, and cervix can be directly biopsied to confirm the diagnosis. If choriocarcinoma is suspected, biopsy should be avoided because uncontrollable massive bleeding from the lesion may occur. ② For patients with uterine bleeding, a diagnostic curettage is often required to confirm the diagnosis or stop bleeding (generally limited to married patients), and the scraped tissue must be subjected to pathological examination. For those suspected of endometrial cancer, segmental diagnostic curettage is performed. That is, the cervical canal is scraped first, then the depth of the uterine cavity is explored and the endometrial tissue is scraped. After the source of the specimens is marked, they are sent for pathological examination to assist in the diagnosis of endometrial cancer.

6. Endoscopic examination

① Hysteroscopy: When B-ultrasound shows abnormal uterine cavity echo, or functional uterine bleeding has been diagnosed and long-term treatment has been ineffective, hysteroscopy is required. To determine whether there are any lesions in the uterine cavity, such as submucosal myoma, endometrial polyps, cancer, etc. ② Laparoscopic examination: If a pelvic mass or endometriosis is found during gynecological examination or B-ultrasound, laparoscopy can provide a definitive diagnosis.