Understanding Abnormal Uterine Bleeding (AUB)

At Montgomery Gynecology, we recognize that Abnormal Uterine Bleeding (AUB) can be a concerning and challenging issue for many women.


It remains one of the most common reasons for gynecology visits, accounting for about one-third of all cases.

Our team provides the expertise and care needed to evaluate and manage AUB comprehensively.

Why AUB Is Concerning

Abnormal Uterine Bleeding can signal underlying conditions such as:

  • Cancer or pre-cancerous changes
  • Hormonal imbalances
  • Blood-clotting disorders

Untimely or heavy bleeding can affect daily life, lead to iron deficiency anemia, and may pose a risk to your overall health if not properly evaluated.

Diagnosing and Understanding AUB

AUB evaluation requires a structured clinical approach:

  • Comprehensive history and physical exam conducted by a board-certified gynecologist
  • Laboratory testing and imaging when indicated to identify the cause
  • Specialized clinical expertise to ensure accurate diagnosis and treatment planning


Defining AUB

AUB refers to menstrual bleeding that differs from normal in:

  • Volume
  • Duration
  • Regularity
  • Frequency

It is important to distinguish uterine bleeding from bleeding that originates from the cervix or vagina. This distinction is made during a pelvic examination.

Common Causes of AUB (PALM–COEIN Classification)

AUB causes are grouped into structural and non-structural categories using the FIGO PALM–COEIN system:

Structural Causes (PALM):

Polyps – growths in the uterine lining

Adenomyosis – uterine lining tissue within the uterine muscle

Leiomyoma (fibroids) – benign growths in the uterine wall

Malignancy and hyperplasia – cancer or pre-cancer of the uterine lining

Non-Structural Causes (COEIN):

Coagulopathy – blood clotting disorders

Ovulatory dysfunction – irregular or absent ovulation

Endometrial causes – disorders of the uterine lining

Iatrogenic – medications or devices (e.g., hormones, IUDs)

Not yet classified – less defined causes

Taking Action for Your Health

If you are experiencing abnormal bleeding, evaluation is important.

Your care plan may include:

  • Blood tests
  • Ultrasound imaging
  • Pap testing
  • Endometrial sampling

In many cases, AUB is benign and treatable once the cause is identified.

To discuss symptoms or schedule an appointment,

Contact Montgomery Gynecology at 215-444-3411.