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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Intermittent Vaginal Bleeding While Suffering From Endometrial Hyperplasia?

17years old ,unmarried female patient presents to outpatient department complaining of intermittent vaginal bleeding for 5 months.patient with anemia and no abdominal pain .vaginal bleeding amount was more than normal menstrual quantity.since the onset she has been loosing weight .no sexual life history .so pelvic examination not done .beta-hcg test is negative.complete blood cell count hemoglobin of 72grans .Ultrasound examination showed the thickness of endometrium was 15mm.whats the diagnosis and differential diagnosis?
Mon, 30 Jul 2018
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General & Family Physician,  's  Response
Hello dear,welcome to Ask a doctor service.
I reviewed your query and here is advise.
The differential diagnosis is done with

Non-pregnancy related
*endometrial carcinoma: variable appearance
*endometrial hyperplasia: usually uniformly hyperechoic and tends to be diffuse. Can be a differential diagnosis of many conditions i.e. PCOS
*endometrial polyp: usually hyperechoic, often focal, look for vascular stalk
*Tamoxifen-related endometrial changes: variable appearances
*hormone replacement therapy (HRT): in postmenopausal female
*endometritis: prominent hyperechoic endometrium +/- fluid and debris
adhesions: irregular echogenic areas with focal thickening
*obstructed outlet
*ovarian tumours associated with endometrial thickening
*endometrioid carcinoma of the ovary
granulosa cell ovarian cancer
I think it may be hormone related and PCOS.
Also check thyroid hormone levels.

Hope I have answered the question.
Let me know if I can assist you further.
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What Causes Intermittent Vaginal Bleeding While Suffering From Endometrial Hyperplasia?

Hello dear,welcome to Ask a doctor service. I reviewed your query and here is advise. The differential diagnosis is done with Non-pregnancy related *endometrial carcinoma: variable appearance *endometrial hyperplasia: usually uniformly hyperechoic and tends to be diffuse. Can be a differential diagnosis of many conditions i.e. PCOS *endometrial polyp: usually hyperechoic, often focal, look for vascular stalk *Tamoxifen-related endometrial changes: variable appearances *hormone replacement therapy (HRT): in postmenopausal female *endometritis: prominent hyperechoic endometrium +/- fluid and debris adhesions: irregular echogenic areas with focal thickening *obstructed outlet *ovarian tumours associated with endometrial thickening *endometrioid carcinoma of the ovary granulosa cell ovarian cancer I think it may be hormone related and PCOS. Also check thyroid hormone levels. Hope I have answered the question. Let me know if I can assist you further.