Menorrhagia Differential Diagnoses

Updated: Jul 19, 2023
  • Author: Julia A Shaw, MD, MBA, FACOG; Chief Editor: Michel E Rivlin, MD  more...
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Diagnostic Considerations

Important considerations

Every patient presenting with uterine bleeding should first undergo pregnancy testing. Threatened or incomplete abortion, ectopic pregnancy, or retained products of conception must be considered before any imaging studies may be ordered.

Every high-risk or postmenopausal patient with uterine bleeding first must be evaluated for endometrial or other gynecological malignancy.

When treating patients with progestin therapy of any form, they must be informed that this is not a form of birth control. Pregnancy is possible, especially if ovulation is induced by the cycling of the progesterone.

All medications and procedures must be administered only after informed consent of all benefits and risks.

Other problems to be considered

Other conditions to consider in patients with suspected menorrhagia include the following:

  • Coagulation disorders

  • Endometrial polyps

  • Genitourinary infection

  • Intrauterine device

  • Liver disease/failure

  • Medications

  • Renal disease/failure

  • Steroid hormones

  • Uterine fibroids

  • Vascular imbalance

  • Adenomyosis

Differential Diagnoses