What diseases can perimenopausal dysfunctional uterine bleeding be confused with?

In clinical practice, it is not easy to accurately diagnose dysfunctional uterine bleeding, and misdiagnosis of "dysfunctional uterine bleeding" often occurs. Abnormal uterine bleeding can be caused by a variety of conditions.

1. Pregnancy and pregnancy-related diseases

(1) Miscarriage: When the patient has no history of menopause but is accompanied by irregular small amount of vaginal bleeding, especially in perimenopause, it is easy to misdiagnose it as dysfunctional uterine bleeding.

(2)ectopic pregnancySome patients with ectopic pregnancy have no history of menopause and irregular vaginal bleeding as the main manifestation, and some can also manifest as a large amount of vaginal bleeding, such as estrogen and progesterone therapy with "dysfunctional uterine bleeding", which can often lead to serious consequences, and fallopian tube pregnancy rupture may occur.

(3) Trophoblastic diseases: patients with perimenopausal molar pregnancy may be ignored the possibility of pregnancy, and patients with choriocarcinoma without a history of molar pregnancy may also be misdiagnosed with dysfunctional uterine bleeding and delay the diagnosis time.

2. Tumors of the reproductive organs

(1)Uterine fibroids: Perimenopausal patients, particularly small submucosal fibroids with irregular vaginal bleeding, may be misdiagnosed. It should be understood that when the uterus is basically normal, there is still the possibility of organic diseases. If treatment for dysfunctional uterine bleeding is ineffective, the diagnosis should be further confirmed.

(2) Malignant tumors of the cervix and uterus: such as endometrial cancer, irregular vaginal bleeding is often the main symptom. If curettage is not performed in a timely manner, it may be misdiagnosed as dysfunctional uterine bleeding and delay treatment.

(3) Functional ovarian tumors: such as ovarian granulosa cell tumor and follicular membrane tumor, which can lead to excessive endometrial hyperplasia due to the estrogen secreted by the tumor, and the diagnosis of ovarian tumor will be delayed if only the treatment of endometrial lesions is treated.

3. Other organic diseases of the genitals are common endometriosis, myomedenosis, pelvic inflammatory disease, pelvic tuberculosis, especially in the early stage of endometrial tuberculosis, and irregular vaginal bleeding caused by endometrial polyps and intrauterine devices are often confused with dysfunctional uterine bleeding.

4. Systemic diseases include acute infection, thrombocytopenia, aplastic anemia, leukemia,cirrhosis, and anticoagulant therapy, etc., may be mistaken for "dysfunctional uterine bleeding" for a period of time.