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Differential diagnosis of abnormal uterine bleeding

Authoring team

  • 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:

  1. 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
  2. Whitaker L, Critchley HOD. Abnormal uterine bleeding. Best Practice & Research Clinical Obstetrics & Gynaecology. 2016;34:54-65.
  3. 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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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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