Update on the management of abnormal uterine bleeding

Area of Science:

• Gynecology
• Reproductive Health
• Clinical Medicine

Background:

• Abnormal uterine bleeding (AUB) is a prevalent gynecological issue affecting women across reproductive ages.
• It leads to significant health consequences like anemia and diminished quality of life, with considerable economic implications.
• Standardized terminology and classification are crucial for effective communication and management of AUB.

Purpose of the Study:

• To emphasize the importance of accurate diagnosis, investigation, and treatment of AUB based on current medical knowledge.
• To introduce and highlight the utility of the PALM-COIEN classification for categorizing AUB etiologies.
• To outline current diagnostic and therapeutic approaches for abnormal uterine bleeding.

Main Methods:

• Evaluation of bleeding through self-reporting and objective measures.
• Focus on diagnosing anemia and identifying underlying causal factors of AUB.
• Utilizing the PALM-COIEN classification to differentiate anatomical and functional causes.
• Employing diagnostic tools such as blood tests, ultrasound, hysteroscopy, and endometrial sampling.
• Considering patient-specific factors like age and pregnancy desires for treatment planning.

Main Results:

• The PALM-COIEN classification provides a framework to distinguish between structural (PALM) and non-structural (COIEN) causes of AUB.
• Diagnostic workup involves assessing for anemia and investigating potential etiologies.
• Treatment strategies encompass medical (iron, hormonal, non-hormonal) and surgical options, tailored to the cause and patient factors.
• Treatment efficacy is assessed using pre-therapeutic evaluation tools, with a focus on improving quality of life.

Conclusions:

• Accurate diagnosis and classification, particularly using the PALM-COIEN system, are fundamental for managing abnormal uterine bleeding.
• A comprehensive approach considering etiology, patient factors, and quality of life is essential for effective AUB treatment.
• Current medical and surgical interventions offer various options for managing AUB, aiming to restore health and well-being.