Clinical QuickieWomen's Health
Abnormal Uterine Bleeding
Stabilize, classify, then treat.
Stability comes first
Tachycardia, orthostasis, syncope, dyspnea, chest symptoms, or ongoing very heavy bleeding changes the urgency.
Pregnancy status is foundational
In reproductive-age patients, pregnancy testing belongs early unless pregnancy is impossible.
Use a structured cause framework
Structural and nonstructural causes can be organized with a framework such as PALM-COEIN; medications, coagulopathy, endocrine disease, and age/endometrial risk matter.
Treatment depends on cause and contraindications
Hormonal therapy, antifibrinolytic therapy, NSAIDs in selected cases, iron replacement, and procedural management each have different roles.
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