Differential diagnosis of abnormal uterine bleeding
- pregnancy and pregnancy related conditions
- abruptio placenta, placenta praevia
- ectopic pregnancy
- miscarriage
- trophoblastic disease
- polyp – endometrial and endocervical
- adenomyosis
- leiomyoma
- hyperplasia
- malignancy – endometrial cancer, cervical cancer, uterine sarcoma
- ovulatory dysfunction;
- polycystic ovarian syndrome (PCOS)
- hyperprolactinaemia
- hypothyroidism
- mental stress
- obesity
- anorexia
- weight loss or extreme exercise such as that associated with elite athletic training
- extremes of reproductive age: adolescence and the menopause transition
- coagulopathy
- Von Willebrand disease
- anticoagulant and antiplatelet therapy
- endometrial
- endometriosis
- endometritis
- iatrogenic
- antidepressants (selective serotonin reuptake inhibitors and tricyclics)
- hormonal contraceptives
- tamoxifen
- antipsychotics (first generation and risperidone)
- corticosteroids
- herbs: ginseng, chaste berry, danshen
- other causes
- arteriovenous malformations
- endometrial pseudoaneurysms
- myometrial hypertrophy (1,2,3)
References:
- Munro MG et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113(1):3-13
- Whitaker L, Critchley HOD. Abnormal uterine bleeding. Best Practice & Research Clinical Obstetrics & Gynaecology. 2016;34:54-65.
- Sweet MG et al. Evaluation and management of abnormal uterine bleeding in premenopausal women. Am Fam Physician. 2012;85(1):35-43.
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