Abnormal uterine bleeding in women of reproductive age: PALM-COEIN causes

K.V. Fedosiuk, Л. В. Пахаренко, K.V. Chaika, I.O. Basiuha, O.O. Kurtash
In: Bangladesh Journal of Medical Science · 2023 · vol. 22(4) , pp. 809–814 · doi:10.3329/bjms.v22i4.67116 · W4386513041
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective analysis of 336 women with abnormal uterine bleeding found PALM causes (polyps, adenomyosis, leiomyoma, malignancy/hyperplasia) were more prevalent than COEIN causes, with rates varying by age.

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This retrospective study analyzed 336 reproductive-age women with abnormal uterine bleeding (2017–2020), assessing social/demographic characteristics, reproductive function, somatic diseases, and categorizing AUB etiologies using the PALM-COEIN system. Among reported causes, leiomyoma accounted for 37.50%, ovulation disorders for 24.11%, adenomyosis for 20.83%, malignancy/hyperplasia for 14.29%, endometrial factors for 12.20%, polyps for 13.39%, and iatrogenic causes for 6.25%. The authors concluded that PALM etiological factors dominated over COEIN factors, with some differences by age period. This paper is centrally about endometriosis and/or adenomyosis—specifically adenomyosis as one of the quantified PALM causes of abnormal uterine bleeding.

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Abstract

Objective: Abnormal uterine bleeding (AUB) is an often pathology in women of reproductive age. Materials and methods. The retrospective analysis of 336 patients with AUB was performed between 2017-2020. We analyzed the social and demographic data, reproductive function, somatic diseases, type and causes of AUB. Results. According to PALM-COEIN classification polyps were found in 13.39 % of patients, adenomyosis – 20.83 %, leiomyoma – 37.50 %, malignancy/hyperplasia – 14.29 %, ovulation disorders – 24.11 %, endometrial factor – 12.20 %, iatrogenic reason – 6.25 %. Conclusion. PALM-causes dominate over COEINetiological factors in the development of AUB in women of reproductive age. But, there are some differences in the rate of causes according to the age period. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 809-814
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Objective

Abnormal uterine bleeding (AUB) is an often pathology in women of reproductive age.

Materials

and methods. The retrospective analysis of 336 patients with AUB was performed between 2017-2020. We analyzed the social and demographic data, reproductive function, somatic diseases, type and causes of AUB. Results. According to PALM-COEIN classification polyps were found in 13.39 % of patients, adenomyosis – 20.83 %, leiomyoma – 37.50 %, malignancy/hyperplasia – 14.29 %, ovulation disorders – 24.11 %, endometrial factor – 12.20 %, iatrogenic reason – 6.25 %. Conclusion. PALM-causes dominate over COEINetiological factors in the development of AUB in women of reproductive age. But, there are some differences in the rate of causes according to the age period. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 809-814 Downloads 520 527 Downloads Published How to Cite Issue Section License Copyright (c) 2023 Kateryna Fedosiuk, Lyudmyla Pakharenko, Kirill Chayka, Iryna Basiuha, Oleg Kurtash This work is licensed under a Creative Commons Attribution 4.0 International License. Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that: - Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work. Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. - Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.

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adenomyosis

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