Pathophysiology of heavy menstrual bleeding.

Area of Science:

• Gynecology
• Reproductive Medicine
• Pathophysiology

Background:

• Heavy menstrual bleeding (HMB) is a prevalent gynecological complaint with varied causes.
• Current understanding of HMB mechanisms and pathological variations remains incomplete.
• The PALM-COEIN classification system offers a framework for abnormal uterine bleeding.

Purpose of the Study:

• To review heavy menstrual bleeding (HMB) in the context of the PALM-COEIN classification.
• To elucidate the endometrial events in normal menstruation and their disruptions in HMB.
• To highlight the need for further research into HMB pathophysiology.

Main Methods:

• Literature review focusing on endometrial events in normal and abnormal menstruation.
• Discussion of perturbations leading to HMB.
• Analysis of HMB in relation to the PALM-COEIN system.

Main Results:

• Normal endometrial shedding involves complex physiological processes.
• Deviations from normal shedding can lead to heavy menstrual bleeding (HMB).
• The PALM-COEIN system provides a structured approach to classifying causes of abnormal uterine bleeding.

Conclusions:

• Further research into the pathophysiology of HMB is essential.
• A deeper understanding of HMB mechanisms will identify new therapeutic targets.
• Improved knowledge is needed to develop more effective HMB treatments.