Differential Diagnosis for a 17-year-old with Severely Painful Regular Menstrual Periods and Heavy Bleeding
- Single most likely diagnosis:
- Dysmenorrhea: This condition is characterized by painful menstrual cramps, which can be severe and are often accompanied by heavy bleeding. It's a common issue among adolescents and young women, making it the most likely diagnosis given the symptoms.
- Other Likely diagnoses:
- Menorrhagia: This refers to abnormally heavy or prolonged menstrual bleeding. While it can occur alone, it often accompanies dysmenorrhea, contributing to the overall discomfort and health concern.
- Endometriosis: Although more commonly diagnosed in older women, endometriosis can occur in teenagers and is known to cause severe menstrual pain and heavy bleeding.
- Uterine Fibroids: Though less common in adolescents, fibroids can cause heavy menstrual bleeding and pain.
- Do Not Miss diagnoses:
- Ectopic Pregnancy: Although the patient reports regular menstrual periods, an ectopic pregnancy can still occur and must be ruled out due to its potentially life-threatening nature.
- Pelvic Inflammatory Disease (PID): PID can cause severe pelvic pain and abnormal bleeding. It's a critical diagnosis not to miss due to its potential for long-term fertility issues.
- Coagulopathy: Bleeding disorders such as von Willebrand disease can lead to heavy menstrual bleeding and should be considered to prevent severe health complications.
- Rare diagnoses:
- Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to painful and heavy periods. It's less common, especially in younger women.
- Ruptured Ovarian Cyst: Can cause severe pain and bleeding, though it might not directly relate to the menstrual cycle timing.
- Uterine Anomalies: Certain congenital anomalies of the uterus can lead to complications including obstructed menstrual flow, leading to severe pain and potentially heavy bleeding when the obstruction is partial.