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Abnormal uterine bleeding

Abnormal uterine bleeding
Abnormal uterine bleeding

Introduction: It is not uncommon for a woman to suffer from abnormal uterine bleeding (AUB) or heavy menstrual bleeding (HMB) at some point during her lifetime. Once pathology is excluded, in practice, management needs to be individualised, taking into account the improvement of the woman's symptoms and quality of life.

Sources of data: Peer-reviewed journals, governmental and professional society publications.

Areas of agreement: There is now agreement on a structured, universal approach to the diagnosis of AUB, with the aide memoirs PALM (polyps, adenomyosis, leiomyoma, malignancy) and COEIN (coagulopathies, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified). Once malignancy and significant pelvic pathology have been ruled out, medical treatment is an effective first-line therapeutic option, with surgery, including endometrial ablation and hysterectomy, offered when medical management has failed to resolve symptoms and fertility is no longer desired.

Areas of controversy: There remains controversy around the management of the types and subtypes of adenomyosis and leiomyoma, and understanding their impact on clinical reproductive outcomes.

Areas currently under development: Standardised assessment tools for measuring outcomes of AUB are being developed.

Areas timely for developing research: Novel diagnostic and monitoring tools should be developed to help stratify treatment for women with AUB, particularly relating to 'unclassified' and 'endometrial' causes.

0007-1420
103-114
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Cameron, Iain T.
f7595539-efa6-4687-b161-e1e93ff710f2
Critchley, Hilary O.D.
ed3b135e-e838-4f69-ac78-22221c061f9d
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Cameron, Iain T.
f7595539-efa6-4687-b161-e1e93ff710f2
Critchley, Hilary O.D.
ed3b135e-e838-4f69-ac78-22221c061f9d

Cheong, Ying, Cameron, Iain T. and Critchley, Hilary O.D. (2017) Abnormal uterine bleeding. British Medical Bulletin, 123 (1), 103-114. (doi:10.1093/bmb/ldx027).

Record type: Article

Abstract

Introduction: It is not uncommon for a woman to suffer from abnormal uterine bleeding (AUB) or heavy menstrual bleeding (HMB) at some point during her lifetime. Once pathology is excluded, in practice, management needs to be individualised, taking into account the improvement of the woman's symptoms and quality of life.

Sources of data: Peer-reviewed journals, governmental and professional society publications.

Areas of agreement: There is now agreement on a structured, universal approach to the diagnosis of AUB, with the aide memoirs PALM (polyps, adenomyosis, leiomyoma, malignancy) and COEIN (coagulopathies, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified). Once malignancy and significant pelvic pathology have been ruled out, medical treatment is an effective first-line therapeutic option, with surgery, including endometrial ablation and hysterectomy, offered when medical management has failed to resolve symptoms and fertility is no longer desired.

Areas of controversy: There remains controversy around the management of the types and subtypes of adenomyosis and leiomyoma, and understanding their impact on clinical reproductive outcomes.

Areas currently under development: Standardised assessment tools for measuring outcomes of AUB are being developed.

Areas timely for developing research: Novel diagnostic and monitoring tools should be developed to help stratify treatment for women with AUB, particularly relating to 'unclassified' and 'endometrial' causes.

Text
Abnormal Menstrual Bleeding Cheong Final with figures and tables and text - Accepted Manuscript
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More information

Accepted/In Press date: 24 July 2017
e-pub ahead of print date: 28 August 2017
Published date: 1 September 2017

Identifiers

Local EPrints ID: 412193
URI: https://eprints.soton.ac.uk/id/eprint/412193
ISSN: 0007-1420
PURE UUID: ed1357e5-1521-4794-a74b-cd6c1b2b679b
ORCID for Ying Cheong: ORCID iD orcid.org/0000-0001-7687-4597
ORCID for Iain T. Cameron: ORCID iD orcid.org/0000-0002-4875-267X

Catalogue record

Date deposited: 13 Jul 2017 16:31
Last modified: 14 Mar 2019 05:45

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