The New Indian Journal of OBGYN. 12(1):60-65

Etiological factors of abnormal uterine bleeding in perimenopausal women in a tertiary care hospital

Susmita Chowdhury, Manideepa Roy

ABSTRACT

Background: The most prevalent menstruation issue during perimenopause is abnormal uterine bleeding (AUB). Diagnosis and treatment of abnormal uterine bleeding in perimenopausal women is important to reduce and prevent the negative impact on physical, emotional, sexual and professional aspects of her life. Aims and objectives: The aim of the study was to document the etiological factors of abnormal uterine bleeding in perimenopausal women and to classify the etiological factors of AUB according to PALM-COEIN classification. Materials and methods: This descriptive hospital based study was conducted in a tertiary care hospital – Silchar Medical College and Hospital, Silchar, Assam, for 1 year from 1st June 2021 to 31st May 2022 after receiving ethical committee approval. The study comprises of 100 perimenopausal patients who presented with AUB to Obstetrics and Gynaecology department. Results: Out of 100 patients the most common sonographic finding was fibroid (35%), whereas 22% had a normal scan, 17% had adenomyosis, 11% had bulky uterus, 8% thickened endometrium and 7% patients had endometrial polyp. The most common endometrial pattern (by D & C and hysterectomy) was proliferative endometrium (39%) followed by secretory endometrium (18%), 10% simple hyperplasia without atypia. After classifying the causes according to PALM-COEIN classification, leiomyoma / AUB-L (38%) was found to be the most common cause followed by adenomyosis / AUB-A (22%). There were 19% cases of ovulatory dysfunction / AUB-O, 12% cases of endometrial disorder (AUB-E), 7% cases of polyp/ AUB-P, 1% case of malignancy / AUB-M and 1% case belonged to AUB-N / not otherwise classified. Conclusion: AUB-L is the most common etiological factor in perimenopausal women. The patients can be treated medically or surgically with maximum precision, after proper classification of AUB by PALM-COEIN, for better success rate.