PALM-COEIN Nomenclature for Abnormal Uterine Bleeding

J Midwifery Womens Health. 2016 May;61(3):376-9. doi: 10.1111/jmwh.12440. Epub 2016 Mar 11.

Abstract

Approximately 30% of women will experience abnormal uterine bleeding (AUB) during their life time. Previous terms defining AUB have been confusing and imprecisely applied. As a consequence, both clinical management and research on this common problem have been negatively impacted. In 2011, the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Group (FMDG) published PALM-COEIN, a new classification system for abnormal bleeding in the reproductive years. Terms such as menorrhagia, menometrorrhagia, metrorrhagia, dysfunctional uterine bleeding, polymenorrhea, oligomenorrhea, and uterine hemorrhage are no longer recommended. The PALM-COEIN system was developed to standardize nomenclature to describe the etiology and severity of AUB. A brief description of the PALM-COEIN nomenclature is presented as well as treatment options for each etiology. Clinicians will frequently encounter women with AUB and should report findings utilizing the PALM-COEIN system.

Keywords: PALM-COEIN; abnormal uterine bleeding; adenomyosis; endometrial cancer; endometrial dysfunction; endometrial intraepithelial neoplasia; leiomyoma; ovarian dysfunction; polyps.

MeSH terms

  • Female
  • Humans
  • Practice Guidelines as Topic
  • Terminology as Topic*
  • Uterine Hemorrhage / classification*
  • Uterine Hemorrhage / diagnosis
  • Uterine Hemorrhage / etiology
  • Uterine Hemorrhage / therapy