Evaluation and Management of Abnormal Uterine Bleeding

Research output: Contribution to journalReview article

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Abstract

Abnormal uterine bleeding (AUB) is a common condition that leads to increased health care costs and decreased quality of life. A systematic approach to AUB evaluation can simplify management and enhance women's well-being. Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Ambiguous and inconsistent use of terminology and definitions to characterize AUB in the past decades necessitated a new, consensus-based approach to nomenclature and AUB evaluation. This led to the International Federation of Gynecology and Obstetrics (FIGO) System 1 in 2007, which standardized nomenclature, set parameters, and defined normal and abnormal bleeding based on the 5th to 95th percentile data from available large-scale epidemiologic studies. FIGO System 1, endorsed by several national and international societies, improved worldwide communication among educators, clinicians, and researchers. FIGO System 2, published in 2011, focused on classifications of AUB etiology into structural and nonstructural entities using the PALM-COEIN (polyp[s], adenomyosis, leiomyoma, malignancy, coagulopathy, ovulatory dysfunction, endometrial disorders, iatrogenic, and not yet classified) classification system. The PALM-COEIN classification is facilitated by a complete patient history combined with appropriate imaging, histopathologic analysis, or laboratory evaluation to ensure accurate diagnostic and treatment approaches to AUB. Herein we present the systematic evaluation of AUB.

Original languageEnglish (US)
Pages (from-to)326-335
Number of pages10
JournalMayo Clinic Proceedings
Volume94
Issue number2
DOIs
StatePublished - Feb 1 2019

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Uterine Hemorrhage
Gynecology
Terminology
Obstetrics
Adenomyosis
Hemorrhage
Menarche
Leiomyoma
Polyps
Health Care Costs
Epidemiologic Studies
Consensus
Communication
Quality of Life
Research Personnel

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Evaluation and Management of Abnormal Uterine Bleeding. / Marnach, Mary L.; Laughlin-Tommaso, Shannon K.

In: Mayo Clinic Proceedings, Vol. 94, No. 2, 01.02.2019, p. 326-335.

Research output: Contribution to journalReview article

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