Differential Diagnosis for White Discharge plus Amenorrhea

Single Most Likely Diagnosis

• Vaginal Yeast Infection: This is a common condition that can cause a white discharge and is often associated with other symptoms such as itching and irritation. Amenorrhea, or the absence of menstruation, can sometimes be related to hormonal imbalances that also predispose to infections like yeast infections.

Other Likely Diagnoses

• Bacterial Vaginosis (BV): Although BV typically presents with a fishy odor and thin discharge, some cases can have a white discharge. It's also associated with hormonal changes and can be linked to amenorrhea indirectly through its impact on reproductive health.
• Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder that can cause amenorrhea due to ovulation problems. It can also lead to an increased risk of vaginal infections, which might present with a white discharge.
• Cervical or Uterine Cancer: Though less common, these conditions can cause abnormal vaginal discharge and amenorrhea, especially in older women or those with risk factors.

Do Not Miss Diagnoses

• Pregnancy: The most critical "do not miss" diagnosis, as it directly relates to amenorrhea. A white discharge can be a normal finding in pregnancy due to hormonal changes.
• Asherman’s Syndrome: A condition characterized by the formation of adhesions in the uterus, often following uterine surgery, which can cause amenorrhea. It might not directly cause a white discharge but is crucial to consider due to its implications on fertility and menstrual health.
• Hypothalamic Amenorrhea: This condition involves a problem with the hypothalamus (a part of the brain) that affects the menstrual cycle, leading to amenorrhea. While it might not directly cause a white discharge, it's a significant diagnosis to consider due to its impact on reproductive and overall health.

Rare Diagnoses

• Genital Tuberculosis: A rare condition in many parts of the world but can cause chronic pelvic inflammation, leading to amenorrhea and abnormal discharge.
• Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: A rare congenital disorder characterized by the absence or underdevelopment of the vagina and uterus, which would lead to primary amenorrhea. While not typically associated with a white discharge, it's a rare condition that could be considered in the differential diagnosis of amenorrhea.