WHAT’S NORMAL ANYWAYS? ABNORMAL UTERINE BLEEDING
WHAT'S NORMAL ANYWAYS? ABNORMAL UTERINE BLEEDING
Aleece Fosnight, MSPAS, PA-C, CSC, CSE Urology, Women's Health, Sexual Medicine
Skin, Bones, Hearts, & Private Parts 2019
DISCLOSURES
Speaker for Lupin Pharmaceuticals.
OBJECTIVES
Define the pathophysiology of abnormal uterine bleeding. Discuss the PALM-COEIN classification system for diagnostic work-up. Develop a treatment plan to include non-surgical and surgical options. Application with clinical presentations through diagnostic work-up
and treatment strategies.
SO...WHAT'S NORMAL?
Follicular Phase Luteal Phase Menstrual Phase
Normal Menstrual Cycle
AKA: Proliferative Phase (Uterine) Early = Epithelium grows Late = Endometrium is thick secondary to mitotic growth of tubular glands Ends = Estradiol peak with LH surge and meiosis of dominant follicle
AKA: Secretory Phase (Uterine) Endometrial stromal height fixed, stroma edematous, glands tortuous, arteries spiral Progesterone from corpus luteum If no hCG, follicular atresia begins
Triggered by the fall in progesterone Vasospasm and ischemic necrosis of the endometrium New follicles = rise in estrogen = endometrial healing
SO...WHAT'S NORMAL?
Frequency of menses Duration of bleeding Volume of Blood Loss
Infrequent = >38 days Shortened = ................
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