REVIEW   

Minerva Ginecologica 2017 February;69(1):75-83

DOI: 10.23736/S0026-4784.16.03944-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Abnormal uterine bleeding unrelated to structural uterine abnormalities: management in the perimenopausal period

Lorenzo SABBIONI, Isabella ZANETTI, Cinzia ORLANDINI, Felice PETRAGLIA, Stefano LUISI ✉

Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy

Abnormal uterine bleeding (AUB) is one of the commonest health problems encountered by women and a frequent phenomenon during menopausal transition. The clinical management of AUB must follow a standardized classification system to obtain the better diagnostic pathway and the optimal therapy. The PALM-COEIN classification system has been approved by the International Federation of Gynecology and Obstetrics (FIGO); it recognizes structural causes of AUB, which can be measured visually with imaging techniques or histopathology, and non-structural entities such as coagulopathies, ovulatory dysfunctions, endometrial and iatrogenic causes and disorders not yet classified. In this review we aim to evaluate the management of nonstructural causes of AUB during the menopausal transition, when commonly women experience changes in menstrual bleeding patterns and unexpected bleedings which affect their quality of life.

KEY WORDS: Metrorrhagia - Blood coagulation disorders - Ovarian diseases - Menstruation disturbances - Perimenopause