FIGO classification system (PALM‐COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age

Munro, Malcolm G.; Critchley, Hilary O. D.; Broder, Michael S.; Fraser, Ian S.

doi:10.1016/j.ijgo.2010.11.011

Cited by 1,272 publications

(1,069 citation statements)

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“…Abnormal uterine bleeding (AUB) is defined as bleeding from uterine corpus which is abnormal in regularity, volume, frequency, and duration of bleeding, and it occurs in the absence of pregnancy [1]. It can be acute and chronic.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding

Godha

Mohsin²,

Hakim³

et al. 2015

J Obstet Gynecol India

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About the Author AbstractPurpose The purpose of this study was to compare the effects of ormeloxifene with medroxyprogesterone acetate in patients with abnormal uterine bleeding. Material and Method 440 Patients were divided into two groups. In group A, ormeloxifene was given at the dosage of 60 mg twice a week for 3 months followed by 60 mg once a week for 1 month. In group B, medroxyprogesterone acetate was given at the dosage of 10 mg twice a day from day 5 to day 25 of the menstrual cycle. At followups, patients were assessed for PBAC score, endometrial thickness by USG, hemoglobin level, and the side effects of drug therapy. Results There were 240 patients in group A and 200 in group B. Reduction in median PBAC score was 79.4 % in group A and 75 % in group B after 4 months of treatment. The mean duration of bleeding reduced to 4.8 from 9 in group A and 5 from 8.7 in group B. Mean hemoglobin was increased from 8.6 to 9.8 g % in group A and from 8.7 to 9.9 g % in group B; endometrial thickness was reduced 123 from 7.7 mm to 6.8 mm in group A and from 7.4 mm to 6.9 mm in group B.Conclusion We conclude from this study that ormeloxifene should be considered the first choice in the management of AUB, especially in the perimenopausal age group where amenorrhea is acceptable.

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Section: Introductionmentioning

confidence: 99%

“…Any patient with AUB should be evaluated regarding her clinical status and severity, etiology, and the most appropriate treatment. The new classification (Table 1) system of etiology of AUB has been proposed by the Menstrual Disorders Working Group of the International Federation of Gynecology and Obstetrics [1].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding

Godha

Mohsin²,

Hakim³

et al. 2015

J Obstet Gynecol India

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“…FIGO designed a new classification system for causes of AUB and called as PALM-COEIN (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified) (Munro et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal uterine bleeding (AUB) is described as bleeding that is excessive or outside the normal menstrual cycle in terms of regularity, volume, frequency, or duration and occurs in the absence of pregnancy (Munro et al, 2011). International Federation of Gynecology and Obstetrics (FIGO) defined a classification system for AUB called as PALM-COEIN (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified) (Munro et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Endometrial Hyperplasia Concomitant Endometrial Polyps in Pre- and Post-menopausal Women

Topçu¹,

Erkaya²,

Güzel³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Purpose: To evaluate the risk factors for endometrial hyperplasia concomitant endometrial polyps in preand post-menopausal women. Materials and Methods: A total of 203 patients undergoing endometrial sampling before hysterectomy were evaluated in this retrospective study. Data recorded were age, gravidity, parity, body mass index (BMI: weight(kg)/height(m) 2 ), endometrial thickness (ET), menopausal status, presence of adenomyosis and diabetes mellitus. Results: Endometrial hyperplasia and polyps were detected in 13 patients. There were statistically significant differences in terms of age, menopausal status, morbid obesity and diabetes mellitus (p<0.005). Logistic regression demonstrated that menopausal status and presence of diabetes mellitus were independent risk factors. Conclusions: According to the current study; menopause and diabetes mellitus are strong risk factors for the presence of concomitant endometrial polyps and endometrial hyperplasia.

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“…AUB may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy (Munro et al, 2011;ACOG, Practice Bulletin, 2012). The recent classification for AUB has been described as PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia-coagulopathy, ovulatory dysfunction, endometrial, iatrogenic and not yet classified), and was approved by the International Federation of Obstetrics (Munro et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia

Mesci-Haftaci

Ankaralı²,

Yavuzcan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia.

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FIGO classification system (PALM‐COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age

Cited by 1,272 publications

References 56 publications

Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding

Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding

Risk Factors for Endometrial Hyperplasia Concomitant Endometrial Polyps in Pre- and Post-menopausal Women

Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia

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