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Review
. 2022 Feb 28:4:820029.
doi: 10.3389/frph.2022.820029. eCollection 2022.

Historical Perspectives and Evolution of Menstrual Terminology

Rohan R Chodankar  1 , Malcolm G Munro  2 , Hilary O D Critchley  3
Affiliations
Review

Historical Perspectives and Evolution of Menstrual Terminology

Rohan R Chodankar et al. Front Reprod Health. .

Abstract

Abnormal uterine bleeding (AUB) in the reproductive years in non-pregnant women comprises a group of symptoms that include abnormal frequency and the irregular onset of flow as well as prolonged and heavy menstrual bleeding. It is a common, chronic, and debilitating condition affecting women worldwide with an adverse impact on their quality of life. Until the last decade, the "menstrual" terminology used to describe both normal and abnormal uterine bleeding and its underlying causes was inconsistent, creating considerable confusion. Using standardized terminology may potentially improve clinical management as well as help designing and interpreting basic, translational, epidemiological, and clinical research in women with menstrual problems. In this article, we explore the history and evolution of menstrual terminology and discuss the two International Federation of Gynecology and Obstetrics (FIGO) systems on i.e., (A) menstrual terminology and definitions (B) and the causes of AUB, achieved through international consensus of relevant stakeholders through a long multistage journey.

Keywords: PALM-COEIN; abnormal uterine bleeding; menstrual disorders; menstrual terminology; menstruation.

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Conflict of interest statement

HC has received clinical research support for laboratory consumables and staff from Bayer AG (paid to Institution) and provides consultancy advice (no personal remuneration) for Bayer AG, PregLem SA, Gedeon Richter, Vifor Pharma UK Ltd, AbbVie Inc, and Myovant Sciences GmbH. HC receives royalties from UpToDate for article on abnormal uterine bleeding. RC has been supported as a clinical research fellow by Bayer AG. MM has received research support from AbbVie Inc and Pharmacosmos, and for consulting services from AbbVie Inc, Daiichi-Sankyo, Hologic Inc, Myovant Sciences, Pharmacosmos, and Vifor Pharma.

Figures

Figure 1
Figure 1
Evolution of the two FIGO Systems. Relevant publications include 2005 (–15), 2007 (16, 17), 2008 (6), 2011 (11), and 2018 (12). FIGO, International Federation of Gynecology and Obstetrics; IJGO, International Journal of Gynecology & Obstetrics; ACOG, American College of Obstetricians & Gynecologists; RCOG, Royal College of Obstetricians & Gynecologists; WHO, World Health Organization; AUB, Abnormal Uterine Bleeding; MDC, Menstrual Disorders Committee.
Figure 2
Figure 2
FIGO AUB System 1 Nomenclature and Definitions of AUB symptoms—The normal menstrual cycle is based on 4 parameters i.e., frequency, duration, regularity, and volume (subjectively determined by patient). The table shows normal values in unshaded areas and abnormalities in each of the parameters in shaded areas. The middle and lower panels are new (vs. 2011 paper); the middle panel is used to describe the presence or absence of IMB, whereas the lower panel is for the description of unscheduled bleeding while using gonadal steroid medication, most often progestogen or estrogen and progestogen-containing preparations.
Figure 3
Figure 3
FIGO AUB System 2. PALM-COEIN system for classification of causes of AUB in the reproductive years. Adapted from Munro et al. (12).
Figure 4
Figure 4
FIGO leiomyoma sub-classification system. Adapted from Munro et al. (12).
See this image and copyright information in PMC

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