Abnormal uterine bleeding

Abnormal uterine bleeding (AUB) is a common and often debilitating condition, affecting women of reproductive age.

AUB is any variance of the normal menstrual cycle, which is defined on the basis of four parameters (frequency, regularity, duration, and volume); symptoms can be acute or chronic.

The International Federation of Gynecology and Obstetrics PALM-COEIN classification system improves the understanding of the causes of AUB, facilitates effective history taking and examination, and allows for shared decision-making towards tailored investigations and management plans.

A range of medical and surgical management options are available, and the choice of treatment is guided by the underlying cause of AUB alongside the woman's age, parity, co-morbidities, need for uterine and fertility preservation, and personal preference.

Abnormal uterine bleeding (AUB) is the term used to describe any symptomatic variation from normal menstruation in terms of regularity, frequency, volume, or duration. AUB also includes symptoms of heavy menstrual bleeding and inter-menstrual bleeding (IMB).[1]Munro MG, Critchley HO, Broder MS, et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011 Apr;113(1):3-13. http://www.ncbi.nlm.nih.gov/pubmed/21345435?tool=bestpractice.com [2]Fraser IS, Critchley HO, Broder M, et al. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011 Sep;29(5):383-90. http://www.ncbi.nlm.nih.gov/pubmed/22065325?tool=bestpractice.com ​ Symptoms of AUB can be either acute (an episode of heavy bleeding of a sufficient volume to require immediate intervention to prevent further blood loss) or chronic (present for more than 6 months), and acute AUB can occur on a background of chronic AUB.