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 release hormones, can cause changes in menstrual bleeding patterns.

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 cancer.
• Pregnancy-Related 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 lead to 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.
• Pituitary Tumors: Although rare, tumors of the pituitary gland can disrupt normal hormonal balance, leading to various menstrual irregularities, including abnormal uterine bleeding.