Hello, I would be happy to help you with your question.
In the setting of abnormal bleeding that is not being easily controlled with hormonal therapy, it is appropriate to undergo a more thorough evaluation that would include:
1. An exam
2. An ultrasound
3. Labs that would include testing for thyroid disease
4. A pregnancy
I hope that this helps. If you have more questions, please click on "ASK ME A QUESTION" link above to directly ask me a question!