Overview
Clinical Meaning
Abnormal uterine bleeding (AUB) is a symptom pattern, not a single diagnosis.
Abnormal uterine bleeding (AUB) is a symptom pattern, not a single diagnosis. PALM-COEIN is FIGO System 2, a framework for classifying potential causes in nongravid patients of reproductive age. It does not apply until pregnancy-related bleeding has been excluded. The description should be specific: frequency, duration, regularity, and volume or effect on quality of life. Heavy menstrual bleeding means menstrual blood loss that interferes with physical, social, emotional, or material quality of life; the patient does not need to measure blood loss for the diagnosis. The clinician is trying to explain the bleeding, not merely label it. The first bedside question is not “Which letter is this?” It is “Is this patient pregnant, unstable, or significantly anaemic?” That sequence prevents a classification system from delaying urgent care.