Abnormal uterine bleeding (AUB) accounts for a third of office visits to a gynecologist. It also accounts for majority of gynecological consults in perimenopausal and postmenopausal women. The International Federation of Gynecology and Obstetrics (FIGO) proposed a classification system with standardized terminology for the causes of AUB. Obtaining a thorough history and physical examination at the initial office visit is important to plan a treatment scheme. Although treatment is individualized, medical therapy is commonly the first-line management especially in young women. For hemodynamically stable patients, common medical treatment options include combination or progestin-only hormonal therapy, gonadotropin-releasing hormone, or tranexamic acid. Patients with contraindications to medical therapy or failed to respond to medical treatment would require surgical options. Similar to medical therapy, surgical management relies on diagnosis, underlying pathology, and patient’s interest in maintaining fertility.
KeywordsAbnormal uterine bleeding Heavy menstrual bleeding International Federation of Gynecology and Obstetrics PALM-COEIN Endometrial polyp Leiomyoma
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