Differential Diagnosis for Menstrual Delay
Single Most Likely Diagnosis
- Pregnancy: This is the most common cause of menstrual delay, and a pregnancy test should be performed to rule it out. Pregnancy can be confirmed with a urine or blood test.
Other Likely Diagnoses
- Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause irregular periods, weight gain, and acne. PCOS is a common endocrine disorder in women of reproductive age.
- Stress and Weight Changes: Significant stress, weight loss, or weight gain can disrupt the menstrual cycle, leading to delays or irregular periods.
- Hypothyroidism: An underactive thyroid gland can cause menstrual irregularities, including delays, due to the impact of thyroid hormones on the reproductive system.
- Hyperprolactinemia: Elevated levels of prolactin can suppress the production of gonadotropin-releasing hormone, leading to menstrual delays.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less likely than a normal pregnancy, an ectopic pregnancy can be life-threatening if not diagnosed promptly. It occurs when a fertilized egg implants outside the uterus.
- Pituitary Tumor: A tumor in the pituitary gland can affect hormone production, including those that regulate the menstrual cycle, and can have serious health implications if left untreated.
- Premature Ovarian Failure: Also known as premature ovarian insufficiency, this condition occurs when the ovaries stop functioning before the age of 40, leading to menstrual irregularities and infertility.
Rare Diagnoses
- Asherman's Syndrome: A rare condition characterized by the formation of scar tissue in the uterus, which can lead to menstrual irregularities, including delays.
- Congenital Adrenal Hyperplasia: A group of inherited disorders that affect the adrenal glands, leading to hormonal imbalances that can cause menstrual irregularities.
- Sheehan's Syndrome: A rare condition that occurs when the pituitary gland is damaged, often due to severe blood loss during childbirth, leading to hormonal deficiencies and menstrual irregularities.