Abnormal uterine bleeding is a common clinical problem that affects women of reproductive age from menarche to menopause. A basic understanding of the causes, pathophysiology and investigation can help guide treatment. Initial treatment is generally medical and can be initiated with confidence once serious pathology, which is rare in the age group, has been excluded.
1. An introduction to the PALM-COEIN mnemonic for the various causes of abnormal uterine bleeding.
2. The role of transvaginal ultrasound, blood tests and endometrial sampling in making a clear diagnosis.
3. Effective medical treatment with tranexamic acid, oral contraceptives, oral and intrauterine progestins and knowing when referral to a gynecologist is advisable.