Differential Diagnosis for Pelvic Pain and Abnormal Uterine Bleeding
Single Most Likely Diagnosis
- Fibroids: Uterine fibroids are a common cause of pelvic pain and abnormal uterine bleeding in women of reproductive age. They can cause heavy or irregular menstrual bleeding, and their location and size can lead to pelvic pressure or pain.
Other Likely Diagnoses
- Endometriosis: This condition, where tissue similar to the lining of the uterus grows outside the uterus, can cause pelvic pain, dysmenorrhea, and abnormal uterine bleeding due to the inflammation and scarring it produces.
- Adenomyosis: Similar to endometriosis, adenomyosis involves tissue similar to the uterine lining growing into the uterine wall, leading to heavy bleeding and pelvic pain.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs, PID can cause pelvic pain and abnormal vaginal bleeding, especially if it involves the endometrium or leads to the formation of adhesions.
- Dysfunctional Uterine Bleeding (DUB): This condition, often related to hormonal imbalances, can cause irregular and heavy menstrual bleeding without an identifiable structural cause.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less common, an ectopic pregnancy can present with pelvic pain and abnormal vaginal bleeding. It is a medical emergency requiring immediate attention.
- Ovarian Torsion: A condition where the ovary twists around its ligaments, cutting off blood supply, ovarian torsion causes severe pelvic pain and can lead to nausea, vomiting, and sometimes abnormal bleeding.
- Malignancy (e.g., Endometrial or Ovarian Cancer): While less common, cancers of the uterus or ovaries can present with pelvic pain and abnormal uterine bleeding, making them critical not to miss.
Rare Diagnoses
- Uterine Arteriovenous Malformation (AVM): A rare condition characterized by abnormal connections between arteries and veins in the uterus, AVMs can cause abnormal uterine bleeding and pelvic pain.
- Schistosomiasis: In endemic areas, this parasitic infection can cause genital lesions leading to pelvic pain and abnormal vaginal bleeding.
- Von Willebrand Disease: A bleeding disorder that can cause heavy menstrual bleeding, though it's more of a contributing factor to abnormal uterine bleeding rather than a direct cause of pelvic pain.