2. Abnormal Uterine Bleeding is vaginal bleeding from
the uterus that is abnormally frequent, last
excessively long, is more than normal, or is irregular.
Normal:
Frequency - 28 +/- 7 days
Duration - 5 - 7 days
Amount - 20 - 80 mls.
3. Objectives
• I. Understanding the symptoms and aetiology of abnormal
uterine bleeding (AUB).
• Define terminology used in AUB
• Understand the symptoms, investigation and management
of AUB
• Understand the causes and investigation of dysmenorrhea
• Understand the action of medication used for menorrhagia
and dysmenorrhea.
4. Terminology
• Amenorrhea
Amenorrhea is the absence of menstrual bleeding.
• Primary amenorrhea is the failure of menses to occur by age 16
years, in the presence of normal growth and secondary sexual
characteristics.
• Secondary amenorrhea is defined as the cessation of menses
sometime after menarche has occurred.
5. •Menorrhagia/hypermenorrhea
menstruation at regular cycle intervals but with excessive flow and
duration
• Metrorrhagia/intermenstrual bleeding
uterine bleeding at irregular intervals, particularly between the
expected menstrual periods
• Menometrorrhagia
is a condition in which prolonged or excessive uterine bleeding
occurs irregularly and more frequently than normal. It is thus a
combination of metrorrhagia and menorrhagia.
• Polymenorrhea
menstrual cycle that is shorter than 21 days.
• Oligomenorrhoea
Regular menses that are more than 35 days apart.
• Post-coital Bleeding. Bleeding after sexual intercourse
• Premenarchal bleeding. Bleeding before menachre.
• Post-menopausal bleeding. Bleeding more than 1 year after
cessation of periods
6. Classification
The PALM COEIN
classification system is
commonly used.
P - polyps
A- adenomyosis
L - Leiomyoma
M - Malignancy
C - coagulopathy
O - ovulatory disorders
E - endometrial
I - Iatrogenic
N - Not classified (others)