Differential Diagnosis for Abnormal Uterine Bleeding
Single Most Likely Diagnosis
- Hormonal Imbalance: This is often the most common cause of abnormal uterine bleeding, particularly in women of reproductive age. Hormonal fluctuations can lead to irregular ovulation, affecting the normal menstrual cycle and resulting in abnormal bleeding patterns.
Other Likely Diagnoses
- Uterine Fibroids: These are common benign tumors that can cause heavy or irregular menstrual bleeding due to their location and size affecting uterine lining shedding.
- Endometrial Hyperplasia: This condition involves the thickening of the uterine lining, which can lead to abnormal uterine bleeding. It's often associated with hormonal imbalance, particularly excess estrogen.
- Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause irregular periods and abnormal uterine bleeding due to ovulation problems and hormonal imbalances.
- Intrauterine Devices (IUDs): Certain types of IUDs, especially those that are non-hormonal, can cause irregular or increased bleeding, especially in the first few months after insertion.
Do Not Miss Diagnoses
- Endometrial Cancer: Although less common, it's crucial to rule out endometrial cancer, especially in postmenopausal women or those with risk factors such as obesity, diabetes, or a family history of endometrial cancer.
- Cervical Cancer: Abnormal vaginal bleeding can be a symptom of cervical cancer, making it essential to include in the differential diagnosis, especially if there's a history of abnormal Pap smears.
- Pregnancy Complications: Ectopic pregnancy or a miscarriage can present with abnormal uterine bleeding and must be considered, especially in women of childbearing age.
- Bleeding Disorders: Conditions like von Willebrand disease can cause heavy menstrual bleeding and should not be overlooked.
Rare Diagnoses
- Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to heavy or painful periods.
- Uterine Arteriovenous Malformations: Rare vascular lesions that can cause abnormal uterine bleeding due to the abnormal connection between arteries and veins.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect menstrual regularity and may cause abnormal uterine bleeding.
- Coagulopathies: Other than von Willebrand disease, other coagulation disorders can lead to abnormal uterine bleeding, though they are less common.