The standard of care is to get it investigated. Though, symptoms resolution by the pill indicates that it is likely to be a hormonal issue. The following investigations are needed for the assessment;
1) Fibroids and polyps of the uterus
2) Endometrial hyperplasia; due to high estrogen.
3) Bleeding disorders.
5) Both hypothyroidism and hyperthyroidism
6) High prolactin
7) Coagulation disorders.
You may need the following investigations to ascertain the cause:
Sonohysterography (saline-infusion sonography)
Complete blood count (CBC)
Total iron-binding capacity
Human chorionic gonadotropin (hCG)
Thyroid function tests
Liver function tests
Kidney function tests
Hormone assays; Luteinizing hormone, follicle-stimulating hormone, and androgen.
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