management of PALM-COEIN causes of abnormal uterine bleeding

Last edited 09/2018 and last reviewed 03/2021

management of PALM-COEIN causes of abnormal uterine bleeding

AUB sub classification

specific treatment

polyp

resection

adenomyosis

surgery: hysterectomy; adenomyomectomy (not frequently performed)

malignancy

surgery +/- adjuvant therapy
high-dose progestogens (if surgery not possible)
palliation (including radiotherapy)

coagulopathy

tranexamic acid
desmopressin acetate (DDVAP)

ovulation

lifestyle modification
cabergoline (if hyperprolactinaemia)
levothyroxine (if hypothyroid)

endometrial

specific therapies await further delineation of underlying mechanisms

not otherwise classified

antibiotics for endometritis
embolisation of AV malformation

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