Current Terminology of Abnormal Uterine Bleeding

Abnormal Uterine Bleeding (AUB), covering all menstrual disorders both in terms of amount, duration, and the occuring time.

• Menorrhagia (a lot of menstrual bleeding) is replaced with Heavy Menstrual Bleeding (HMB).
• Metroragia (bleeding between menstrual cyclic and predictable) is replaced by Intermenstrual Bleeding (IMB).
• Dysfunctional Uterine Bleeding (DUB) is a coagulopathy disorder, endometrial hemostasis disorders, and disorders of ovulation, the term was abolished.

Current FIGO Classification

AUB based on the cause called PALM-COEIN:

1. PALM is a polyp, Adenomyosis, leiomyoma, malignancy-hyperplasia. Can be diagnosed visually by imaging techniques and / or histopathology (AUB Structural).
2. COEIN is coagulopathy, ovulatory dysfunction, Endometrial, iatrogenic, and Not yet classified (called DUB at the past). Can not be determined by imaging or histopathology (AUB Non-Structural).

Based on the volume, length, or when the bleeding occur, AUB is divided into:

1. Acute abnormal uterine bleeding is defined as a heavy menstrual bleeding so it needs to be done quicker handling to prevent blood loss. Acute abnormal uterine bleeding can also occur in conditions of chronic AUB or without previous history.
2. Chronic abnormal uterine bleeding is abnormal uterine bleeding that has occurred more than 3 months. This condition usually does not require precise handling.
3. Bleeding at the middle of cycle(intermenstrual bleeding) is menstrual bleeding that occurs between the cyclic and predictable. Can happen at any time or place at the same time every cycle. This term is intended to replace the terminology of metroragia.

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