Dysfunctional uterine bleeding differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Arooj Naz ,Vishnu Vardhan Serla M.B.B.S. [2]

Overview

There are many differential diagnosis' for dysfunctional uterine bleeding, many of them resulting in abnormal presentation of bleeding. Some prevalent conditions include anatomical or structural defects, coagulation disorders, pregnancy related complications, endometrial cancer and hyperplasia, as well as Polycystic Ovarian Syndrome.

Differential Diagnosis

Differential Diagnosis
Condition Common Underlying Causes Workup
Anatomic or structural lesions Pelvic or transvaginal Ultrasonography
Coagulation disorders Coagulation studies; PT, aPTT, Bleeding Time, and clotting factor studies
Pregnancy complications B-hCG should be the first test to detect the presence of pregnancy. Visualization of the defect requires pelvic or transvaginal ultrasonography
Endometrial cancer[1] Risk factors include: Upon transvaginal ultrasonography, endometrial cancer will present as a thicked endometrial strip. Confirmation requires an endometrial biopsy.
Endometrial hyperplasia
  • Exogenous estrogen
  • Excess of endogenous estrogen
  • DUB (dysfunctional uterine bleeding) is a diagnosis of exclusion
Endometrial hyperplasia realted changes may be seen on ultrasonography. Obtaining a detailed history of medication use may be of assistance in coming to a diagnosis.
Polycystic Ovarian Syndrome (Stein Leventhal Syndrome) [2] Risk factors include: PCOS may initially be suspected upon physical examination, commonly presenting with hirsutism and weight gain. Confirmation requires FSH/LH level abnormalities as well as multiple ovarian cysts seen on ultrasonography.

Other Causes

Apart from common diseases, there are some other causes that may be potential differential diagnosis'. These include:

References

  1. "StatPearls". 2022. PMID 30252237.
  2. Sirmans SM, Pate KA (2013). "Epidemiology, diagnosis, and management of polycystic ovary syndrome". Clin Epidemiol. 6: 1–13. doi:10.2147/CLEP.S37559. PMC 3872139. PMID 24379699.
  3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016

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