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Abnormal uterine bleeding (AUB) in premenopausal women has many causes, classified by the PALM-COIEN system. Diagnosis involves history, pelvic exam, and tests, with treatments ranging from medication to surgery.

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Area of Science:

  • Gynecology
  • Reproductive Medicine
  • Women's Health

Background:

  • Abnormal uterine bleeding (AUB) is a frequent gynecological complaint in premenopausal women.
  • AUB is defined by deviations in bleeding frequency, duration, volume, or regularity.
  • The PALM-COIEN system provides a standardized classification for AUB etiologies.

Purpose of the Study:

  • To outline the diagnostic approach for abnormal uterine bleeding in premenopausal women.
  • To present the current treatment modalities for abnormal uterine bleeding.
  • To emphasize the importance of a systematic evaluation for AUB.

Main Methods:

  • Comprehensive patient history, including menstrual, sexual, and family history.
  • Physical examination, including speculum and bimanual pelvic examination.
  • Laboratory investigations such as pregnancy testing and complete blood count (CBC) with platelets.

Main Results:

  • Etiologies of AUB can be systematically classified using the PALM-COIEN system.
  • Diagnostic workup includes thorough history, physical exam, and specific tests.
  • Treatment strategies are tailored to the underlying cause of AUB.

Conclusions:

  • Effective management of abnormal uterine bleeding requires accurate diagnosis based on the PALM-COIEN classification.
  • Treatment options for AUB encompass both medical (e.g., hormonal therapies, tranexamic acid) and surgical interventions (e.g., endometrial ablation, hysterectomy).
  • A multidisciplinary approach ensures optimal patient outcomes for premenopausal women experiencing AUB.