The International Federation of Gynecology and Obstetrics (FIGO) uses the mnemonic PALM-COEIN to classify causes of abnormal uterine bleeding.

Patient selection: nonpregant woman of reproductive age


Abnormal uterine bleeding (AUB) may be:

(1) heavy menstrual bleeding (HMB) or

(2) intermenstrual bleeding (IMB)


Structural causes (PALM):

(1) polyp (P)

(2) adenomyosis (A)

(3) leiomyoma (L): submucosal (LSM) or other (LO)

(4) malignancy or hyperplasia (M)


Nonstructural causes (COEIN):

(1) coagulopathy (C)

(2) ovulatory dysfunction (O)

(3) endometrial (E)

(4) iatrogenic (I)

(5) not yet classified (N)

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