Differential Diagnosis for Heavy Uterine Bleeding
Single Most Likely Diagnosis
- Dysfunctional Uterine Bleeding (DUB): This is the most common cause of heavy uterine bleeding, especially in women of reproductive age. It is characterized by irregular, heavy, or prolonged menstrual bleeding without any identifiable structural cause.
Other Likely Diagnoses
- Uterine Fibroids: These are common benign tumors that can cause heavy menstrual bleeding due to their size, location, and effect on the uterine lining.
- Endometrial Hyperplasia: A condition where the lining of the uterus grows too thick, leading to heavy or irregular bleeding. It's more common in perimenopausal women.
- Adenomyosis: A condition where tissue similar to the lining inside the uterus is found outside its normal location, leading to heavy and painful periods.
Do Not Miss Diagnoses
- Endometrial Cancer: Although less common, it is crucial to rule out endometrial cancer, especially in postmenopausal women or those with risk factors like obesity, diabetes, or a family history of cancer.
- Pregnancy-Related Complications: Ectopic pregnancy or a spontaneous abortion can present with heavy 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
- Uterine Arteriovenous Malformations (AVMs): Rare vascular anomalies that can cause heavy, life-threatening bleeding.
- Uterine Cancer (Other Than Endometrial): Such as uterine sarcomas, which are rare but can present with abnormal uterine bleeding.
- Systemic Diseases: Certain systemic diseases, like thyroid disorders or coagulopathies, can rarely cause heavy uterine bleeding.