Differential Diagnosis for Menorrhagia
Single Most Likely Diagnosis
- Dysfunctional Uterine Bleeding (DUB): This is the most common cause of menorrhagia, accounting for approximately 50% of cases. It is characterized by irregular, heavy menstrual bleeding without any identifiable structural or systemic cause.
Other Likely Diagnoses
- Uterine Fibroids: These are benign tumors that can cause heavy or prolonged menstrual bleeding. They are common in women of reproductive age and can be a significant cause of menorrhagia.
- Endometrial Hyperplasia: This condition involves the thickening of the uterine lining, which can lead to heavy or irregular menstrual bleeding.
- Adenomyosis: A condition where tissue similar to the lining of the uterus grows into the uterine walls, leading to heavy bleeding and pain.
- Hormonal Imbalance: Imbalances in estrogen and progesterone levels can disrupt menstrual cycles, leading to heavy or irregular bleeding.
Do Not Miss Diagnoses
- Cancer (Endometrial, Cervical, or Uterine): Although rare, cancer can cause menorrhagia. It is crucial to rule out these conditions, especially in women over 35 or with risk factors.
- Bleeding Disorders (e.g., von Willebrand Disease): These conditions can cause heavy menstrual bleeding due to impaired blood clotting.
- Thyroid Disorders: Both hypothyroidism and hyperthyroidism can affect menstrual cycles, leading to heavy or irregular bleeding.
- Pregnancy-Related Complications: Ectopic pregnancy, miscarriage, or placental abnormalities can cause heavy vaginal bleeding.
Rare Diagnoses
- Uterine Arteriovenous Malformations: Abnormal connections between arteries and veins in the uterus can cause heavy bleeding.
- Uterine Polyps: Growths on the uterine lining can lead to heavy or irregular menstrual bleeding.
- Inherited Bleeding Disorders (e.g., Hemophilia): Although rare in women, these conditions can cause significant bleeding problems, including menorrhagia.
- Systemic Diseases (e.g., Liver or Kidney Disease): Certain systemic conditions can affect blood clotting or hormone regulation, leading to heavy menstrual bleeding.