Study of Abnormal Uterine Bleeding in Women of Perimenopausal Age

Background: Abnormal uterine bleeding (AUB) is a common gynaecological problem in perimenopausal women and often results from hormonal imbalance or underlying uterine pathology. Early evaluation is essential to exclude premalignant and malignant conditions and to guide appropriate management. Objectives: To study the clinical profile, etiological factors, bleeding patterns, and treatment modalities of abnormal uterine bleeding in perimenopausal women. Materials and Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology at K.M. Medical College and Hospital from March 2020 to August 2021. A total of 100 perimenopausal women aged 40–55 years presenting with abnormal uterine bleeding were included. Detailed clinical evaluation, relevant investigations, endometrial assessment, and classification of aetiology using the PALM–COEIN system were performed. Data were analysed using SPSS software. Results: The majority of patients were aged 41–45 years (54%). Menorrhagia was the most common bleeding pattern (66%). Mild anaemia was observed in 40% of patients. According to the PALM–COEIN classification, adenomyosis (AUB-A) was the most frequent aetiology (37%). Most patients required surgical management, with dilatation and curettage with polypectomy (32%) and laparoscopic hysterectomy with bilateral salpingo-oophorectomy (28%) being the common procedures. Endometrial histopathology predominantly showed benign patterns, though atypical hyperplasia was observed in a small proportion of cases. Conclusion: Abnormal uterine bleeding in perimenopausal women is multifactorial, with adenomyosis being the leading cause. Early evaluation, endometrial assessment, and individualised management are essential to improve outcomes and prevent complications.