Tests of uterine function primarily evaluate the condition and function of the uterus and endometrium.
(1) Diagnostic Dilatation and Curettage (D&C)
Indicated for married women, this procedure assesses the depth and width of the uterine cavity and detects adhesions in the endocervical canal or uterine cavity. Endometrial tissue is obtained for pathological examination to evaluate the endometrial response to ovarian hormones and to diagnose endometrial tuberculosis. The curetted specimen may also be cultured for Mycobacterium tuberculosis.
(2) Hysterosalpingography (HSG)
This imaging exam shows the shape and size of the uterine cavity and the patency of the fallopian tubes. It is used to diagnose hypoplasia, congenital malformations, tuberculosis, intrauterine adhesions, and other abnormalities of the reproductive system.
(3) Hysteroscopy
Hysteroscopy allows direct visualization of the uterine cavity and endometrium. It is highly accurate in diagnosing intrauterine adhesions and suspected tuberculous lesions. Biopsies are routinely taken during the procedure for histopathological confirmation.
(4) Medication Withdrawal Tests
① Progesterone Challenge Test A simple and rapid method to estimate endogenous estrogen levels. If no withdrawal bleeding occurs after progesterone administration, it indicates low estrogen levels.
② Estrogen Test If no bleeding occurs after the progesterone test, an estrogen trial is performed. Still no bleeding suggests a defective or damaged endometrium, consistent with the diagnosis of uterine amenorrhea.