What is the first line diagnostic tool in abnormal uterine bleeding?

Endometrial sampling should be performed in patients with AUB older than 45 years as a first-line test. The ACOG supports adopting the PALM-COEIN nomenclature system developed by FIGO to standardize the terminology used to describe AUB.

What are some causes of AUB?

What Causes Abnormal Uterine Bleeding? Most of the time, AUB happens because of changes in the body’s hormone levels. For teen girls, one of the most common causes of hormone changes is when the body doesn’t release an egg from one of the ovaries. This is called anovulation .

How common is AUB?

Abnormal Uterine Bleeding (AUB): Symptoms, Causes and Treatment. Abnormal uterine bleeding (AUB), a term that refers to menstrual bleeding of abnormal quantity, duration, or schedule, is a common gynecologic problem, occurring in approximately 10 to 35 percent of women.

Is menorrhagia same as abnormal uterine bleeding?

Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia.

How do you test for menorrhagia?

Menorrhagia is diagnosed with a pelvic exam, ultrasound, pap test, and sometimes a biopsy. Treatment includes hormones, or other medicine, or procedures to treat the uterine lining or remove the uterus.

What are the symptoms of menorrhagia?

Signs of menorrhagia include:

• Soaking 1 or more tampons or pads every hour for many consecutive hours.
• Doubling up on pads.
• Changing pads or tampons during the night.
• Long-lasting menstrual periods (longer than 7 days)
• Blood clots the size of a quarter or larger.
• Bleeding that is keeping you from doing normal activities.

Is bleeding for 20 days normal?

Menorrhagia is the medical term for menstrual bleeding lasting for longer than 7 days. About 1 in every 20 women has menorrhagia. Some of the bleeding can be very heavy, meaning you would change your tampon or pad after less than 2 hours. It can also mean you pass clots the size of a quarter or even larger.

What are the symptoms of abnormal uterine bleeding?

The primary symptoms associated with abnormal uterine bleeding include:

• Spotting or bleeding between menstrual periods.
• Spotting or bleeding after sex.
• Spotting or bleeding after menopause.
• Menstrual periods that last longer than seven days.
• Soaking a tampon or pad in one hour or less during your menstrual period.

What does hormonal bleeding look like?

Breakthrough bleeding refers to vaginal bleeding or spotting that occurs between menstrual periods or while pregnant. The blood is usually either light red or dark reddish brown, much like the blood at the beginning or end of a period. However, depending on the cause, it may resemble regular menstrual blood.

Can a hormone imbalance cause bleeding?

In many women, a hormone imbalance causes bleeding. These women may have too much estrogen or not enough progesterone. Polyps or fibroids (small and large growths) in the uterus can also cause bleeding.

How can I stop abnormal uterine bleeding?

Abnormal Uterine Bleeding Treatment

1. Hormones. Birth control pills and other hormone treatments may be able to give you regular menstrual cycles and lighter periods.
2. Gonadotropin-releasing hormone agonists (GnRHa). These stop your body from making certain hormones.
3. NSAIDS.
4. Tranexamic acid.
5. IUD.

What does big blood clots in period mean?

Your period may start or end with bright red blood clots, too. This means the blood is flowing quickly and doesn’t have time to darken. When your menstrual flow is heavier, blood clots tend to be bigger because there’s a larger amount of blood sitting in the uterus.

How is PALM COEIN used in menstrual disorders?

The Menstrual Disorders Working Group was set up by the International Federation of Gynecology and Obstetrics (FIGO) to address these issues and to develop an agreed set of terms and definitions. The group developed a classification system – PALM-COEIN – which can be used to describe both structural and non-structural causes of AUB.

How to diagnose uterine bleeding with PALM COEIN?

  Diagnostic evaluation may include ultrasound evaluation and direct visualization of the uterine cavity by hysteroscopy along with tissue sampling. The evaluation leads to a diagnosis, which by PALM COEIN is a structural or non- structural reason.

What does PALM COEIN stand for in medical terms?

The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

What is the etiology of menorrhagia in men?

The PALM-COEIN table is available for review under the etiology section of this article and has led to the terms menorrhagia (prolonged or excessive bleeding), oligomenorrhea (bleeding greater than 35 days), intermenstrual bleeding (bleeding between cycles), and postmenopausal bleeding to fall out of favor.