Differential Diagnosis for a 12-year-old with Painful Menstrual Period, Hair Loss, and Vomiting

• Single Most Likely Diagnosis
  • Dysmenorrhea with associated symptoms: This condition is characterized by painful menstrual cramps and can be accompanied by other symptoms such as nausea, vomiting, and in some cases, hair loss due to nutritional deficiencies or stress. The age and symptoms presented make this a likely diagnosis.
• Other Likely Diagnoses
  • Polycystic Ovary Syndrome (PCOS): PCOS can cause irregular menstrual periods, hair loss (due to hormonal imbalances), and sometimes nausea and vomiting. It's a common endocrine disorder in women of reproductive age.
  • Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause menstrual irregularities, hair loss, and gastrointestinal symptoms like nausea and vomiting. Thyroid issues are relatively common and can present with a wide range of symptoms.
  • Premenstrual Dysphoric Disorder (PMDD): While primarily associated with mood symptoms, PMDD can also include physical symptoms like painful periods and might be accompanied by hair loss and vomiting in severe cases.
• Do Not Miss Diagnoses
  • Eating Disorders: Conditions like bulimia nervosa can lead to vomiting, hair loss (due to malnutrition), and menstrual irregularities. Early detection is crucial for effective treatment and prevention of long-term health consequences.
  • Adrenal Insufficiency: Though rare, adrenal insufficiency can cause a variety of symptoms including nausea, vomiting, hair loss, and menstrual irregularities. It's a life-threatening condition if not treated promptly.
  • Pituitary Tumors: Tumors affecting the pituitary gland can disrupt hormone production, leading to a range of symptoms including menstrual irregularities, hair loss, and sometimes nausea and vomiting.
• Rare Diagnoses
  • Androgen Insensitivity Syndrome: A rare condition where an individual is genetically male but has resistance to male hormones, leading to female physical characteristics but with testes instead of ovaries. It can cause hair loss and irregular periods but is much less common.
  • Congenital Adrenal Hyperplasia (CAH): A group of inherited disorders that affect the adrenal glands, leading to hormone imbalances. It can cause a variety of symptoms including hair loss, menstrual irregularities, and sometimes nausea and vomiting, though it's relatively rare.