Dysfunctional uterine bleeding differential diagnosis: Difference between revisions

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__NOTOC__
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{{Dysfunctional uterine bleeding}}
{{Dysfunctional uterine bleeding}}
{{CMG}}[[User:AroojNaz|Arooj Naz]] ,{{VVS}}
{{CMG}} {{AE}}[[User:AroojNaz|Arooj Naz, M.B.B.S]] ,{{VVS}}
==Overview==
==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 complications|pregnancy]] related complications, [[endometrial cancer]] and [[hyperplasia]], as well as [[Polycystic Ovarian Syndrome]].
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 complications|pregnancy]] related complications, [[endometrial cancer]] and [[hyperplasia]], as well as [[Polycystic Ovarian Syndrome]].
==Differential Diagnosis==
==Differential Diagnosis==
Differential diagnosis' for dysfunctional uterine bleeding include anatomical defects, [[coagulation disorders]], [[pregnancy complications]], and endometrial conditions such as [[Endometrial cancer|malignancy]] and [[PCOS]].
{| class="wikitable"
{| class="wikitable"
|+
|+
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*Uterine or [[cervical polyp]]s
*Uterine or [[cervical polyp]]s
*[[Uterine leiomyoma]]
*[[Uterine leiomyoma]]
*Foreign body
*[[Foreign body]]
|Pelvic or transvaginal [[Ultrasonography]]
|Pelvic or transvaginal [[Ultrasonography]]
|-
|-
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*[[Spontaneous abortions|Spontaneous abortion]]
*[[Spontaneous abortions|Spontaneous abortion]]
*[[Placenta previa]]
*[[Placenta previa]]
|[[Human chorionic gonadotropin|B-hCG]] should be the first test to detect the presence of pregnancy. Visualization of the defect requires pelvic or transvaginal [[ultrasonography]]
|[[Human chorionic gonadotropin|B-hCG]] should be the first test to detect the presence of [[pregnancy]]. Visualization of the defect requires pelvic or transvaginal [[ultrasonography]]
|-
|-
|[[Endometrial cancer]]<ref name="pmid30252237">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=30252237 | doi= | pmc= | url= }}</ref>
|[[Endometrial cancer]]<ref name="pmid30252237">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume=  | issue=  | pages=  | pmid=30252237 | doi= | pmc= | url= }}</ref>
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*Excess of endogenous estrogen
*Excess of endogenous estrogen
*DUB (dysfunctional uterine bleeding) is a diagnosis of exclusion
*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.
|[[Endometrial hyperplasia]] related 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]]) <ref name="pmid24379699">{{cite journal| author=Sirmans SM, Pate KA| title=Epidemiology, diagnosis, and management of polycystic ovary syndrome. | journal=Clin Epidemiol | year= 2013 | volume= 6 | issue=  | pages= 1-13 | pmid=24379699 | doi=10.2147/CLEP.S37559 | pmc=3872139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24379699  }}</ref>
|[[Polycystic Ovarian Syndrome]] ([[Stein Leventhal Syndrome]])<ref name="pmid24379699">{{cite journal| author=Sirmans SM, Pate KA| title=Epidemiology, diagnosis, and management of polycystic ovary syndrome. | journal=Clin Epidemiol | year= 2013 | volume= 6 | issue=  | pages= 1-13 | pmid=24379699 | doi=10.2147/CLEP.S37559 | pmc=3872139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24379699  }}</ref>
|Risk factors include:
|Risk factors include:


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*[[Obesity]]
*[[Obesity]]
*[[Hereditary]] factors
*[[Hereditary]] factors
|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]].
|[[Polycystic ovary syndrome|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===
===Other Causes===
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*Immature hypothalamic-pituitary-ovarian axis
*Immature hypothalamic-pituitary-ovarian axis
*Peri-menopause
*Peri-menopause
*Psychological distress <ref>Sailer, Christian, Wasner, Susanne.  Differential Diagnosis Pocket.  Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref>
*Psychological distress<ref>Sailer, Christian, Wasner, Susanne.  Differential Diagnosis Pocket.  Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref>


==References==
==References==

Latest revision as of 01:13, 7 August 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S ,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' for dysfunctional uterine bleeding include anatomical defects, coagulation disorders, pregnancy complications, and endometrial conditions such as malignancy and PCOS.

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 related 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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