Differential Diagnosis for Pelvic Pain in a 43-year-old Female
Single Most Likely Diagnosis
- Endometriosis: This condition is a common cause of pelvic pain in women of reproductive age, especially those in their 40s. It occurs when tissue similar to the lining inside the uterus grows outside of it, leading to pain, inflammation, and scarring.
Other Likely Diagnoses
- Uterine Fibroids: These are non-cancerous growths of the uterus that can cause pelvic pain, heavy menstrual bleeding, and pressure on the bladder or bowel.
- Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to painful periods and pelvic pain.
- Ovarian Cysts: Fluid-filled sacs on the ovaries that can cause pelvic pain if they rupture or bleed.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause pelvic pain, fever, and abnormal vaginal discharge.
- Irritable Bowel Syndrome (IBS): A gastrointestinal disorder that can cause abdominal and pelvic pain, bloating, and changes in bowel movements.
Do Not Miss Diagnoses
- Ectopic Pregnancy: A pregnancy that develops outside the uterus, which can cause severe pelvic pain and is life-threatening if not treated promptly.
- Ovarian Torsion: A condition where the ovary twists around its ligaments, cutting off blood supply and causing severe pelvic pain.
- Appendicitis: Inflammation of the appendix that can cause abdominal and pelvic pain, nausea, and vomiting.
- Diverticulitis: Inflammation of the diverticula in the colon that can cause pelvic pain, fever, and changes in bowel habits.
Rare Diagnoses
- Lymphoma or Other Cancers: Although rare, cancers such as lymphoma, ovarian cancer, or uterine cancer can cause pelvic pain and should be considered in the differential diagnosis.
- Interstitial Cystitis: A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain.
- Tarlov Cysts: Rare, fluid-filled sacs in the spine that can cause pelvic pain, among other symptoms.
- Pudendal Neuralgia: A condition that causes chronic pain in the pelvic area due to irritation of the pudendal nerve.