Causes of Abnormal Uterine Bleeding Non-pregnant bleeding that is inegular in timing, frequency, or flow Mnemonic: PALM-COEIN STRUCTURAL CAUSES Polyps - Endometrial - Cervical Adenomyosis - Painful heavy periods in women 30s-40s Leiomyoma - Increase in size in pregnancy or with OCPs Malignancy / hyperplasia - Consider in all peri- and postmenopausal women NON-STRUCTURAL CAUSES Coagulopathy - Undiagnosed coagulopathy in adolescents - Acquired (anticoagulants, cirrhosis) Ovulatory dysfunction - Adolescents - Perimenopause - PCOS - Hypothyroidism - Anorexia - Athletes Endometrial causes - Diagnosis of exclusion Iatrogenic - Hormonal contraceptive use - Hormone replacement therapy - Post-GYN surgery Not otherwise classified - Endometritis - Cervical erosions, cervicitis - Vaginal trauma - Foreign bodies #AUB #Abnormal #Uterine #Bleeding #Mnemonic #PALMCOEIN #Diagnosis #Obstetrics #Gynecology #Differential #Causes
