In November 2010, the International Federation of Gynecology and Obstetrics formally
accepted a new classification system for causes of abnormal uterine bleeding in the
reproductive years. The system, based on the acronym PALM-COEIN (polyps, adenomyosis,
leiomyoma, malignancy and hyperplasia–coagulopathy, ovulatory disorders, endometrial
causes, iatrogenic, not classified) was developed in response to concerns about the
design and interpretation of basic science and clinical investigation that relates
to the problem of abnormal uterine bleeding. A system of nomenclature for the description
of normal uterine bleeding and the various symptoms that comprise abnormal bleeding
has also been included. This article describes the rationale, the structured methods
that involved stakeholders worldwide, and the suggested use of the International Federation
of Gynecology and Obstetrics system for research, education, and clinical care. Investigators
in the field are encouraged to use the system in the design of their abnormal uterine
bleeding–related research because it is an approach that should improve our understanding
and management of this often perplexing clinical condition.
Key words
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Article info
Publication history
Published online: February 10, 2012
Accepted:
January 31,
2012
Received in revised form:
January 13,
2012
Received:
November 29,
2011
Footnotes
Funded by an unrestricted educational grant to the Association of Academic Health Centers from TAP Pharmaceuticals, Chicago, IL, and Schering AG, Berlin, Germany; subsequent funding was provided by an unrestricted grant to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists by Bayer Women's Health, Berlin, Germany.
All authors act as consultants to Bayer Health Care; H.O.D.C. has received support for research collaboration from Bayer Pharma AG and also past support (research grant) from TAP Pharmaceutical Products Inc; I.S.F. has received research grants from Bayer Health Care.
Reprints not available from the authors.
Identification
Copyright
© 2012 Published by Elsevier Inc.
