University of Colorado, UC Heath Internal Medicine - Lowry, 8111 E. Lowry boulevard, Denver, CO 80230, USA.
University of Kentucky, 1000 S. Limestone, Lexington, KY 40536, USA.
Med Clin North Am. 2023 Mar;107(2):235-246. doi: 10.1016/j.mcna.2022.10.014. Epub 2022 Dec 26.
Abnormal uterine bleeding is a common problem in premenopausal women and refers to uterine bleeding that is abnormal in frequency, duration, volume, and/or regularity. Etiologies can be classified using the PALM-COIEN system. Patients should receive a comprehensive history and physical with special attention to menstrual, sexual, and family history. Physical examination needs to include a pelvic examination with speculum and bimanual components. All patients need to have a pregnancy test and CBC with platelets. Treatments vary by etiology. Medical treatments include levonorgestrel intrauterine devices, oral contraceptive pills, and tranexamic acid. Surgical treatment options include endometrial ablation and hysterectomy.
异常子宫出血是绝经前妇女的常见问题，是指频率、持续时间、量和/或规律性异常的子宫出血。病因可以采用 PALM-COEIN 系统进行分类。患者应接受全面的病史和体格检查，特别注意月经、性生活和家族史。体格检查需要包括阴道镜和双合诊的盆腔检查。所有患者均需要进行妊娠试验和全血细胞计数加血小板。治疗方法因病因而异。药物治疗包括左炔诺孕酮宫内节育器、口服避孕药和氨甲环酸。手术治疗选择包括子宫内膜消融和子宫切除术。
