Female Pelvic Conditions: Abnormal Uterine Bleeding

Area of Science:

• Gynecology
• Reproductive Medicine

Background:

• Abnormal uterine bleeding (AUB) is a common gynecological condition.
• It replaces older, less precise terms like dysfunctional uterine bleeding and menorrhagia.
• The PALM-COEIN system classifies AUB causes into structural (PALM) and non-structural (COEIN) categories.

Purpose of the Study:

• To provide a comprehensive overview of abnormal uterine bleeding.
• To outline the classification system for AUB etiologies.
• To discuss the diagnostic and management approaches for AUB.

Main Methods:

• Review of existing literature and clinical guidelines for abnormal uterine bleeding.
• Description of the PALM-COEIN classification system for AUB.
• Summary of diagnostic evaluation, including history, physical examination, and endometrial biopsy criteria.
• Overview of medical and surgical management options for AUB.

Main Results:

• Abnormal uterine bleeding (AUB) has a prevalence of 35% or higher.
• History and physical examination are crucial for AUB evaluation.
• Endometrial biopsy is indicated for specific risk factors in women under 45, and for all women over 45 or with postmenopausal bleeding.
• Medical therapies (oral contraceptives, IUDs, tranexamic acid, NSAIDs) and surgical procedures are used for management.

Conclusions:

• Abnormal uterine bleeding (AUB) management is etiology-dependent.
• Individualized treatment plans are essential, considering the patient's fertility goals.
• The PALM-COEIN classification aids in understanding and managing AUB.