3 learning resources available for this topic
Abnormal uterine bleeding (AUB) refers to any variation from normal menstrual patterns in frequency, regularity, duration, or volume of menstrual flow. It affects up to 30% of reproductive-aged women and can significantly impact quality of life, requiring systematic evaluation to identify underlying causes and appropriate treatment.
AUB results from disruption of the normal hypothalamic-pituitary-ovarian axis or structural abnormalities of the reproductive tract. The PALM-COEIN classification system categorizes causes into structural abnormalities (polyps, adenomyosis, leiomyomas, malignancy) and non-structural causes (coagulopathy, ovulatory disorders, endometrial dysfunction, iatrogenic factors).
Evaluation begins with comprehensive history and physical examination to assess bleeding patterns, associated symptoms, and risk factors for specific conditions. Initial workup includes pregnancy testing, complete blood count, and pelvic examination, with additional studies like ultrasound, endometrial biopsy, or hormonal assessments based on patient age, symptoms, and clinical presentation to guide targeted treatment strategies.