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To the Editor.—
In Dr Altcheck's reply in the QUESTIONS AND ANSWERS section (233:182, 1975), I think the author should have also included an ultrasound examination of the pelvis as one of the procedures to be recommended if no cause of bleeding can be visualized on speculum examination. We have been able to discover unsuspected pregnancy, masses, pelvic inflammatory disease, and other findings quickly and "noninvasively."
Krause DA. Abnormal Menstrual Bleeding. JAMA. 1975;234(10):1019. doi:10.1001/jama.1975.03260230019015