The FIGO Ovulatory Disorders Classification System

Munro, Malcolm G.; Balen, Adam; Cho, SiHyun; Critchley, Hilary; Díaz, Inmaculada Clotilde Santos; Ferriani, Rui Alberto; Henry, Laurie; Mocanu, Edgar; Spuy, Zephne M van der

doi:10.1016/j.fertnstert.2022.07.009

Cited by 19 publications

(19 citation statements)

References 36 publications

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“…Recently, a classification system for ovulatory disorders was developed under the aegis of FIGO by the Committees for Menstrual Disorders and Related Health Impacts (formerly the Menstrual Disorders Committee) and Reproductive Endocrinology and Infertility 79–81 . The development involved journal editors, recognized experts, and national, subspecialty, and lay societies from around the world to achieve international consensus for replacing a system developed over 50 years ago by the WHO.…”

Section: Figo Systemmentioning

confidence: 99%

Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2

Jain

Munro

Critchley

2023

Intl J Gynecology & Obste

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Abnormal uterine bleeding (AUB) is common, often debilitating, and may affect over 50% of reproductive‐aged women and girls. Whereas AUB is a collection of symptoms that include intermenstrual bleeding and abnormalities in period duration, cycle length, and regularity, it is heavy menstrual bleeding (HMB) that is most contributory to iron deficiency and related anemia. It is apparent that AUB, in general, and HMB, in particular, remain underrecognized and underreported. FIGO created two systems for assessing and classifying AUB. FIGO System 1 defines the bleeding pattern using four primary descriptors: frequency, duration, regularity, and flow volume. FIGO System 2 provides a structured classification system of possible causes of AUB, using the acronym PALM‐COEIN. “PALM” refers to structural causes of AUB (Polyp, Adenomyosis, Leiomyoma, Malignancy), and “COEI” refers to nonstructural causes (Coagulopathy, Ovulatory dysfunction, Endometrial, and Iatrogenic). The “N” is reserved for those entities that are currently not otherwise classified. Using FIGO System 1 as a gateway to FIGO System 2 streamlines the investigation of reproductive‐aged women and girls with AUB. Understanding the pathogenesis of the FIGO System 2 “PALM‐COEIN” causes helps interpret investigations and the onward management of AUB. Numerous evidence gaps exist concerning AUB; however, if researchers and trialists universally adopt FIGO Systems 1 and 2 for the assessment and diagnosis of AUB, clear translatable research findings can be applied globally.

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Section: Figo Systemmentioning

confidence: 99%

Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2

Jain

Munro

Critchley

2023

Intl J Gynecology & Obste

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“…In the same year, a systematic review of the role of cesarean scar defect and AUB was published in Fertility and Sterility . A FIGO classification and reporting system for adenomyosis has been developed, and publication will follow a validation exercise sometime in 2023. a Munro and Lukes, 2 Kadir et al, 3 Lukes et al, 4 Fraser et al, 5 Kouides et al 6 b Fraser et al 8 c Munro et al 9 d Munro et al 12 e Munro et al, 28 Munro et al, 29 Munro et al 30 f Murji et al 31 …”

Section: Figurementioning

confidence: 99%

“…15 One result of this expanded domain was the realization that the ID and iron deficiency anemia (IDA) that develop secondary to HMB also contribute greatly to the ID diagnosed in pregnancy. 3 Lukes et al, 4 Fraser et al, 5 28 Munro et al, 29 Munro et al 30 f Murji et al 31 Furthermore, not only does ID have a potentially significant adverse impact on obstetric outcomes such as preterm labor and peripartum hemorrhage, it is also associated with fetal growth restriction and, especially, neurodevelopmental impairment that may begin in the first trimester and appears to have manifestations that continue to adulthood. 1,16,17 This means that the causes of ID in nonpregnant women, including HMB, are major contributors to the ID experienced in early pregnancy, with all its attendant and potentially enduring adverse impacts on the fetus.…”

Section: E D I T O R I a L Our Path From Abnormal Uterine Bleeding An...mentioning

confidence: 99%

Our path from abnormal uterine bleeding and iron deficiency to impaired fetal development: A long and winding road

Munro

Critchley

2023

Intl J Gynecology & Obste

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“…Studies have shown that structural causes such as endometrial polyps, adenomyosis, uterine leiomyoma, and endometrial malignancy, as well as nonstructural causes such as systemic coagulation disorders, ovulatory dysfunction, endometrial abnormalities, and iatrogenic factors, are risk factors for AUB [8][9][10][11] . Ovulatory dysfunction is the most common reason for AUB and accounts for approximately 50% of all AUB patients.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Choices for Ovulatory Dysfunctional Abnormal Uterine Bleeding: A Cross-sectional Study in Chinese Women

Zhao

Luo

Tian

2023

Preprint

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Background Ovulatory dysfunction is the primary cause of abnormal uterine bleeding (AUB); however, data on nationwide therapeutic choices of Chinese women are lacking. The aim of this study was to investigate the therapeutic choices of ovulatory dysfunctional abnormal uterine bleeding (AUB-O) in Chinese women and analyse the factors on the selection results.Methods This was a cross-sectional study involving 3527 patients with AUB-O diagnosed by local doctor between 14 and 55 years old. We used questionnaire compiled according to the Chinese AUB-O treatment guidelines to collect the demographic and therapeutic information. Their therapeutic choices were regarded as generally representative of the nation ’s choices.Results The patients were divided into the juvenile group (14–18 years old, n = 84), the reproductive group (19–39 years old, n = 2962) and the senior group (perimenopausal period: 40–55 years old, n = 481). The results showed that irregular menstruation (37.6% − 46.3%), dysmenorrhea (29.9% − 44.4%), and heavy menstrual bleeding (16.7% − 32.2%) were the main symptoms in Chinese AUB-O patients of different ages. Most of the patients chose to seek help in the Department of General Gynecology (78.6% − 90.7%). Among the therapeutic options, combined oral contraceptives (COCs), such as Yasmin I and Yasmin II, met the treatment expectations with high acceptance among patients (36.6%-52.2%).Conclusions It is important to strengthen the endocrine diagnosis ability of doctors in the Department of General Gynecology. With rational education and clinical applications, COCs are expected to become a more prevalent therapeutic option for AUB-O.

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The FIGO Ovulatory Disorders Classification System

Cited by 19 publications

References 36 publications

Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2

Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2

Our path from abnormal uterine bleeding and iron deficiency to impaired fetal development: A long and winding road

Therapeutic Choices for Ovulatory Dysfunctional Abnormal Uterine Bleeding: A Cross-sectional Study in Chinese Women

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