Differential Diagnosis for Daily Menstrual Bleeding with IUD
- Single most likely diagnosis
- Intrauterine device (IUD) malfunction or expulsion: The IUD may not be in the correct position or may have been expelled, leading to a return of menstrual bleeding.
- Other Likely diagnoses
- Uterine polyps or fibroids: Growth of polyps or fibroids in the uterus can cause irregular and prolonged menstrual bleeding, even with an IUD in place.
- Hormonal imbalance: Changes in hormone levels can affect menstrual bleeding patterns, potentially causing daily bleeding.
- Infection or inflammation: Pelvic inflammatory disease (PID) or other infections can cause bleeding irregularities.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Uterine cancer: Although rare, uterine cancer can cause abnormal vaginal bleeding and should be considered in the differential diagnosis.
- Ovarian cancer: Similar to uterine cancer, ovarian cancer can also cause abnormal bleeding and should not be missed.
- Ectopic pregnancy: Although the patient has an IUD, there is still a small chance of pregnancy, and ectopic pregnancy can be life-threatening if not diagnosed promptly.
- Rare diagnoses
- Von Willebrand disease: A bleeding disorder that can cause heavy or prolonged menstrual bleeding.
- Uterine arteriovenous malformation (AVM): A rare condition where there is an abnormal connection between arteries and veins in the uterus, leading to bleeding.
- Systemic diseases (e.g., bleeding disorders, liver disease): Certain systemic diseases can affect menstrual bleeding patterns, although these are less common causes of daily menstrual bleeding with an IUD.