Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) covers any bleeding that is heavy, prolonged, frequent, or unpredictable. Evaluation often uses the PALM-COEIN framework to identify structural and non-structural causes.

Table of Contents

PALM-COEIN

  • Polyp
  • Adenomyosis
  • Leiomyoma (fibroid)
  • Malignancy/hyperplasia
  • Coagulopathy
  • Ovulatory dysfunction
  • Endometrial causes
  • Iatrogenic (e.g., IUDs, anticoagulants)
  • Not otherwise classified

Evaluation

  • Pregnancy test
  • Pelvic ultrasound
  • Hormonal labs as indicated
  • Endometrial biopsy for postmenopausal bleeding or risk factors

Related Conditions

Heavy Menstrual Bleeding

Common

 Menorrhagia

Specific

 Endometrial Polyps

Cause
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • ACOG. AUB Practice Bulletin.