Differential Diagnosis for Increased Abdominal Pain with Increased Menstrual Cramping

Single Most Likely Diagnosis

• Dysmenorrhea: This condition is characterized by painful menstrual cramps, which can also cause increased abdominal pain. It is a common issue among women and is often associated with heavy menstrual bleeding, nausea, and vomiting. The pain typically starts just before or at the onset of menstruation and can last for several days.

Other Likely Diagnoses

• Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pain, especially during menstruation. It can cause severe abdominal pain, heavy bleeding, and infertility.
• Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to painful and heavy periods.
• Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause abdominal pain, fever, and abnormal vaginal discharge. It is often caused by sexually transmitted bacteria.
• Ovarian Cysts: Fluid-filled sacs on the ovaries that can cause pain, especially if they rupture or twist.

Do Not Miss Diagnoses

• Ectopic Pregnancy: A pregnancy that develops outside the uterus, often causing severe abdominal pain and vaginal bleeding. It is a medical emergency that requires immediate attention.
• Appendicitis: Inflammation of the appendix that can cause severe abdominal pain, nausea, and vomiting. If left untreated, it can lead to a ruptured appendix, which is life-threatening.
• Ovarian Torsion: A condition where the ovary twists around its ligaments, cutting off blood supply and causing severe pain. It is a medical emergency that requires immediate surgical intervention.

Rare Diagnoses

• Interstitial Cystitis: A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can worsen during menstruation.
• Uterine Fibroids: Non-cancerous growths in the uterus that can cause heavy menstrual bleeding, prolonged menstrual periods, and pelvic pain.
• Intrauterine Adhesions (Asherman's Syndrome): A condition where scar tissue forms inside the uterus, leading to lighter or absent periods, and can cause pain during menstruation.
• Chronic Pelvic Pain Syndrome: A condition characterized by chronic pain in the pelvic region, often associated with other symptoms like urinary frequency and pain during intercourse.