Abnormal Uterine Bleeding

Female Reproductive System & Breast


Clinicals - History

Fact Explanation
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Abnormal uterine bleeding (AUB) is any type of bleeding from the uterus that is out of the range of normal menstruation. It is a common complaint that is often multifactorial, and that can significantly interfere with the woman\u0027s quality of life.\n\nThe mnemonic \u0022PALM-COEIN\u0022 can be used to recall the etiologies causing AUB. Here, \u0022PALM\u0022 refers to structural causes, i.e., polyps, adenomyosis, leiomyoma, and malignancy; COEIN refers to non-structural causes, i.e., coagulopathies, ovulatory disorders, endometrial disorders, iatrogenic procedures, and \u0022not otherwise classified\u0022 conditions."}]}
{"ops":[{"insert":"AUB: heavy menstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can present as heavy menstrual bleeding (HMB), i.e., a blood loss of \u003E80 mL per cycle, with or without additional symptoms. This was previously termed \u0022hypermenorrhea\u0022.\n\nIn the absence of additional findings, this form of AUB is associated with ovulatory cycles."}]}
{"ops":[{"insert":"AUB: prolonged menstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can manifest as prolonged menstrual bleeding, i.e., menstruating for \u003E8 days. This was previous called \u0022menometrorrhagia\u0022. This finding is suggestive of anovulation."}]}
{"ops":[{"insert":"AUB: irregular menstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can also manifest as irregular menstrual bleeding, i.e., occurring at intervals with a 20 day variation or more; earlier this was termed \u0022menometrorrhagia\u0022. Similar to prolonged menstrual bleeding, this too is suggestive of anovulation."}]}
{"ops":[{"insert":"AUB: intermenstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can present as bleeding that occurs outside the normal menstrual period. Earlier, this was termed \u0022metrorrhagia\u0022. This is triggered by poor corpus luteal development and inadequate progesterone secretion."}]}
{"ops":[{"insert":"Bladder and bowel dysfunction"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of associated obstructive or irritative bowel and bladder symptoms is strongly suggestive of uterine fibroids."}]}
{"ops":[{"insert":"Pelvic pain"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of chronic pelvic pain favors adenomyosis, especially if this is markedly exacerbated during menstruation. Acute severe pelvic pain may occur in fibroid degeneration."}]}
{"ops":[{"insert":"Subfertility"},{"insert":"\n"}]}
{"ops":[{"insert":"Subfertility is a common accompaniment. When associated with intermenstrual bleeding, this is more likely to be due to hormonal imbalances. Alternately, this may be due to structural causes (e.g., uterine polyps and fibroids) distorting the uterine cavity and interfering with implantation."}]}
{"ops":[{"insert":"Symptoms of anemia"},{"insert":"\n"}]}
{"ops":[{"insert":"Symptoms of anemia include fatigue, weakness, pallor, and dizziness. These are typically a consequence of HMB."}]}
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Abnormal uterine bleeding (AUB) is any type of bleeding from the uterus that is out of the range of normal menstruation. It is a common complaint that is often multifactorial, and that can significantly interfere with the woman\u0027s quality of life.\n\nThe mnemonic \u0022PALM-COEIN\u0022 can be used to recall the etiologies causing AUB. Here, \u0022PALM\u0022 refers to structural causes, i.e., polyps, adenomyosis, leiomyoma, and malignancy; COEIN refers to non-structural causes, i.e., coagulopathies, ovulatory disorders, endometrial disorders, iatrogenic procedures, and \u0022not otherwise classified\u0022 conditions."}]}
{"ops":[{"insert":"AUB: heavy menstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can present as heavy menstrual bleeding (HMB), i.e., a blood loss of \u003E80 mL per cycle, with or without additional symptoms. This was previously termed \u0022hypermenorrhea\u0022.\n\nIn the absence of additional findings, this form of AUB is associated with ovulatory cycles."}]}
{"ops":[{"insert":"AUB: prolonged menstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can manifest as prolonged menstrual bleeding, i.e., menstruating for \u003E8 days. This was previous called \u0022menometrorrhagia\u0022. This finding is suggestive of anovulation."}]}
{"ops":[{"insert":"AUB: irregular menstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can also manifest as irregular menstrual bleeding, i.e., occurring at intervals with a 20 day variation or more; earlier this was termed \u0022menometrorrhagia\u0022. Similar to prolonged menstrual bleeding, this too is suggestive of anovulation."}]}
{"ops":[{"insert":"AUB: intermenstrual bleeding"},{"insert":"\n"}]}
{"ops":[{"insert":"AUB can present as bleeding that occurs outside the normal menstrual period. Earlier, this was termed \u0022metrorrhagia\u0022. This is triggered by poor corpus luteal development and inadequate progesterone secretion."}]}
{"ops":[{"insert":"Bladder and bowel dysfunction"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of associated obstructive or irritative bowel and bladder symptoms is strongly suggestive of uterine fibroids."}]}
{"ops":[{"insert":"Pelvic pain"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of chronic pelvic pain favors adenomyosis, especially if this is markedly exacerbated during menstruation. Acute severe pelvic pain may occur in fibroid degeneration."}]}
{"ops":[{"insert":"Subfertility"},{"insert":"\n"}]}
{"ops":[{"insert":"Subfertility is a common accompaniment. When associated with intermenstrual bleeding, this is more likely to be due to hormonal imbalances. Alternately, this may be due to structural causes (e.g., uterine polyps and fibroids) distorting the uterine cavity and interfering with implantation."}]}
{"ops":[{"insert":"Symptoms of anemia"},{"insert":"\n"}]}
{"ops":[{"insert":"Symptoms of anemia include fatigue, weakness, pallor, and dizziness. These are typically a consequence of HMB."}]}

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