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Abstract
Introduction: Abnormal uterine bleeding (AUB) is a common gynecological problem in reproductive-age women. It affects physical, reproductive, and social well-being. Identifying its pattern and causes supports appropriate evaluation and management.
Objective: To determine the pattern of AUB among women aged 18–45 years attending the gynecology outpatient department and to classify cases using the FIGO PALM-COEIN system.
Methods: This descriptive cross-sectional study was conducted at the Primary Health Center, Sikanderabad, from November 2025 to April 2026. Using consecutive sampling, 320 women were recruited. Data were collected with a structured questionnaire, and body mass index was calculated. Causes were classified as structural (PALM) or non-structural (COEIN).
Results: The mean age was 31.6 ± 7.2 years. Most women were multiparous (62.5%), and 61.3% were overweight or obese. Heavy menstrual bleeding was the most common pattern (34.4%), followed by irregular (25.0%) and prolonged bleeding (18.8%). Non-structural causes accounted for 55.9% of cases and structural causes for 44.1%. Leiomyoma and ovulatory dysfunction were the leading causes (20.0% each).
Conclusion: AUB is a significant gynecological burden. Standardized PALM-COEIN classification, together with assessment of demographic and reproductive factors, supports accurate diagnosis and management.