Dysfunctional uterine bleeding differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Differential Diagnosis

• Anatomic or structural lesions

  • Uterine or cervical polyps
  • Uterine leiomyoma
  • Foreign body

• Coagulation disorders

  • Clotting factor disorder: Hemophilia, hepatic disease, anticoagulant use, renal disease, Von Willebrand's Disease
  • Platelet dysfunction: Leukemia, Thrombocytopenia, and related medications

• Pregnancy complications

  • Placental abruption
  • Ectopic Pregnancy
  • Miscarriage
  • Spontaneous abortion
  • Placenta previa

• Endometrial cancer

  • Risk Factors:

    • Diabetes Mellitus
    • Unopposed estrogen
    • Obesity
    • Older age
    • Chronic anovulation
    • Hypertension

• Endometrial hyperplasia

  • Exogenous extrogen
  • Excess of endogenous estrogen
  • DUB (dysfunctional uterine bleeding) is a diagnosis of exclusion

• Endometrioma
• Hyperprolactinemia
• Hypo- or Hyperthyroidism
• Hypothalamic lesion
• Medications (e.g., Norepinephrine)
• Nonuterine bleeding

  • Rectal
  • Urinary
  • Vaginal
  • Cervical

• Other malignancy
• Pelvic infection
• Polycystic Ovarian Syndrome (Stein Leventhal Syndrome)
• Systemic disease
• Anorexia Nervosa
• Immature hypothalamic-pituitary-ovarian axis
• Intense exercise
• Nutritional status (Very low calorie diets)
• Peri-menopause
• Psychologic stress