Differential Diagnosis for Prolonged Period

Single Most Likely Diagnosis

• Hormonal Imbalance: This is often the most common cause of prolonged menstrual periods, particularly due to fluctuations in estrogen and progesterone levels. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or the use of certain medications can lead to hormonal imbalances.

Other Likely Diagnoses

• Uterine Fibroids: These are growths in the uterus that can cause heavy or prolonged menstrual bleeding. They are common in women of reproductive age and can significantly affect menstrual flow.
• Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to heavy and prolonged periods.
• Endometrial Hyperplasia: A condition characterized by the thickening of the lining of the uterus, which can cause prolonged and heavy menstrual bleeding.

Do Not Miss Diagnoses

• Cancer (Uterine, Cervical, or Ovarian): Although less common, cancer can cause irregular and prolonged menstrual bleeding. It is crucial to rule out these conditions due to their severe implications.
• Bleeding Disorders (e.g., von Willebrand Disease): These conditions can lead to prolonged or heavy bleeding due to difficulties in blood clotting.
• Pregnancy Complications: Ectopic pregnancy or a miscarriage can present with prolonged vaginal bleeding.

Rare Diagnoses

• Arteriovenous Malformations (AVMs): Rare vascular lesions that can cause abnormal bleeding, including prolonged menstrual periods.
• Uterine Agenesis or Other Mullerian Anomalies: Rare congenital conditions affecting the development of the female reproductive tract, which can lead to abnormal menstrual bleeding patterns.
• Systemic Diseases (e.g., Bleeding Disorders, Coagulopathies): Certain systemic conditions can affect clotting and lead to prolonged menstrual bleeding, though these are less common causes.