Differential Diagnosis for Postmenopausal Bleeding
Single Most Likely Diagnosis
- Atrophic Vaginitis: This is the most common cause of postmenopausal bleeding, resulting from the thinning and drying of the vaginal walls due to decreased estrogen levels.
Other Likely Diagnoses
- Endometrial Hyperplasia: A condition where the lining of the uterus grows too thick, which can be caused by an imbalance of hormones, particularly estrogen without the balancing effects of progesterone.
- Endometrial Polyps: Growths in the lining of the uterus that can cause bleeding, especially in postmenopausal women.
- Hormone Replacement Therapy (HRT): Bleeding can occur in women on HRT due to the hormonal stimulation of the endometrium.
Do Not Miss Diagnoses
- Endometrial Cancer: Although less common, it is crucial to rule out endometrial cancer as it can present with postmenopausal bleeding. Early detection significantly improves prognosis.
- Cervical Cancer: Another critical diagnosis not to miss, as it can also present with abnormal vaginal bleeding in postmenopausal women.
Rare Diagnoses
- Uterine Sarcoma: A rare type of cancer that originates in the muscle and supporting tissues of the uterine walls.
- Ovarian Cancer: While primarily associated with other symptoms, ovarian cancer can occasionally present with postmenopausal bleeding, though this is uncommon.
- Vaginal Cancer: A rare type of cancer that can cause bleeding, especially if the tumor is located near the vaginal opening or on the vaginal walls.