Clinical evaluation of abnormal vaginal bleeding

A. A menstrual and reproductive history is obtained, including last menstrual period, regularity, duration, frequency; the number of pads used per day, and intermenstrual bleeding.

B. Stress, exercise, weight changes and systemic diseases, particularly thyroid, renal or hepatic diseases, or coagulopathies should be sought. The method of birth control should be determined.

C. Pregnancy complications, such as spontaneous abortion, ectopic pregnancy, placenta previa and abruptio placentae, can cause heavy bleeding. Pregnancy should always be considered as a possible cause of abnormal vaginal bleeding.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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