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Review
. 2025 Jun;52(2):181-192.
doi: 10.1016/j.pop.2024.12.003. Epub 2025 Feb 8.

Lifecycle Approach to Abnormal Uterine Bleeding

Bethany Howlett  1 , Viktoriya Ovsepyan  2 , Taylor Ross  3 , Jensena Carlson  4
Affiliations
Review

Lifecycle Approach to Abnormal Uterine Bleeding

Bethany Howlett et al. Prim Care. 2025 Jun.

Abstract

Abnormal uterine bleeding (AUB) is experienced by nearly one-third of patients with a uterus and is commonly addressed in the primary care setting. Abnormal uterine bleeding, defined as deviations from the normal regularity, frequency, heaviness, or duration of flow, may be disruptive to daily life and often leads to secondary complications such as anemia and infertility. Causes and presentations of AUB vary across the lifecycle and the International Federation of Gynecology and Obstetrics System 2 mnemonic PALM-COEIN can assist in understanding both the structural and non-structural etiologies of abnormal uterine bleeding.

Keywords: Abnormal uterine bleeding; PALM-COEIN; PCOS; Postmenopausal bleeding.

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Conflict of interest statement

Disclosure The authors have nothing to disclose.