Living Reference Work Entry

Handbook of Gynecology

pp 1-18

Date: Latest Version

Abnormal Vaginal Bleeding During the Early Reproductive Years

  • Anita L. NelsonAffiliated withDavid Geffen School of Medicine at UCLA Email author 


New terminology was introduced by the Menstrual Disorder Working Group of the International Federation of Gynecology and Obstetrics (FIGO) and approved by ACOG several years ago to facilitate accurate descriptions of all dimension of each woman’s bleeding. These descriptors better characterize abnormal uterine bleeding patterns than the older imprecise terms, such as “dysfunctional uterine bleeding” and “menorrhagia.” The new PALM-COEIN classification system was implemented shortly thereafter to standardize reporting of etiologies of abnormal bleeding. Utilizing these new tools and current practice guidelines, this chapter will provide an overview of the differential diagnoses, evaluations, and treatment of women presenting with abnormal uterine bleeding from adolescence through the end of a woman’s reproductive years.


Abnormal uterine bleeding Amenorrhea Infrequent bleeding Postcoital bleeding Intermenstrual bleeding Heavy menstrual bleeding PCOS