EMplify - September 2021

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Abnormal Uterine Bleeding in the Emergency Department

Authors:

Tazeen Abbas, MD

Abbas Husain, MD, FACEP

Physiology review
Terminology
Differentiating Causes: PALM-COEIN
Structural: Polyp, Adenomyosis, Leiomyoma, Malignancy/Hyperplasia
Non-structural: Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not otherwise specified
Other causes: thyroid disease, hyperprolactinemia, stress, weight loss and anorexia, heavy exercise
Age Based Differential
12-18
Immaturity of the hypothalamic-pituitary- ovarian axis
Sexually transmitted infections
Coagulopathies, and bleeding disorders (von Willibrand disease)
19-39
polyps
fibroids
malignancy
PCOS
Age 40 and older
endometrial atrophy
malignancy
History
Physical Exam
Diagnostic Studies
Treatment
Unstable
Stable
Special Cases
DOACs
Prepubescent girls
genital injuries

Episode 61 - Abnormal Uterine Bleeding

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Episode 61 - Abnormal Uterine Bleeding