AUB (Abnormal Uterine Bleeding)

Question 1

How is it diagnosed and what are its common differential diagnoses?

Answer 1

• AUB has many possible causes.
• Its diagnosis requires comprehensive, focused history.
• Differential diagnoses vary by patient’s age and history.

Question 2

When should AUB (abnormal uterine bleeding) patients be referred to OB/GYN?

Answer 2

ALWAYS refer to rule out cancer (via transvaginal ultrasound or biopsy)!!!

Question 3

Who is at high risk with AUB (abnormal uterine bleeding)?

Answer 3

Postmenopausal women = HIGH RISK!!!

• ANY bleeding beyond 12 months since LMP (last menstrual period)
• Even a single drop of blood is concerning!
• 9% risk of endometrial cancer

Question 4

What are the structural causes of AUB (abnormal uterine bleeding) and their associated ages that correspond with the acronym PALM?

Answer 4

Diagnosis/Cause: Age:

P Polyps >30
A Adenomyosis (uterine scarring) >30
L Leiomyoma/fibroids >30
M Malignancy/hyperplasia >40

(Obesity, DM, PCOS >50)

Question 5

What are the structural causes of AUB (abnormal uterine bleeding) and their associated ages that correspond with the acronym COEIN?

Answer 5

Diagnosis/Cause: Age:

C Coagulopathy ANY
O Ovulatory dysfunction ANY
E Endometrial disorders ANY
I Iatrogenic, medications ANY
N Not classified ANY