Adolescent abnormal uterine bleeding – The PALM COEIN approach

Sharma, Ila; Singh, Neetu; Mansukhani, Chandra; Gujral, Kanwal

doi:10.1016/j.cmrp.2015.06.002

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Menstrual pattern disorders occur in 9-14% of women of childbearing age (between menarche and menopause) and have a significant impact on quality of life (3) . Risk factors that can affect menstrual pattern disorders are physical activity, stress, polycystic ovary syndrome, hyperprolactinemia, hypothyroidism, immaturity of hypothalamic pituitary ovarian axis, obesity and anorexia (4) (5) . The level of moderate or heavy physical activity can affect the menstrual phase.…”

Section: Introductionmentioning

confidence: 99%

Menstrual Pattern Disorder Related to Physical Activity and Stress Psychic Soldiers Female Student of Indonesian Navy

Pratami¹,

Herawati²,

Annas³

2020

IJPHRD

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A disorder of menstrual patterns in women of productive age can have an impact on quality of life, risk factors for menstrual pattern disorders include physical activity and psychological stress. The purpose of the study was to analyse the correlation between physical activity and stress relations with the pattern of correlations between female students in the Indonesian Navy's First Bintara Education. This research was an observational analytic study using cross sectional study. The sample in this study was 95 female students. For measuring the grade of physical activity using the International Physical Activity Questionnaire (IPAQ) the grade of psychological stress using Depression Anxiety Stress Scale 42 (DASS 42), and monitoring patterns of menstrual patterns in the first 3 months during military education, then analysed using bivariate. The results of statistical tests using Chi Square obtained p value of physical activity that has (p = 0.008; OR 24.3) and stress (p = 0.019), showing related correlations related to physical activity and psychological stress on the correlation of menstrual patterns in the troops female soldiers in military education.

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Section: Introductionmentioning

confidence: 99%

Menstrual Pattern Disorder Related to Physical Activity and Stress Psychic Soldiers Female Student of Indonesian Navy

Pratami¹,

Herawati²,

Annas³

2020

IJPHRD

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Systematic review and meta-analysis of the etiology of heavy menstrual bleeding in 2,770 adolescent females

Hall,

Ravelo,

Aronoff

et al. 2024

BMC Women's Health

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Background Adolescent heavy menstrual bleeding(HMB), menorrhagia or abnormal uterine bleeding commonly occur in adolescent women. The differential diagnosis can be challenging. The pneumonic: PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified), is commonly used but it does not stratify as to the likelihood of a disorder. We have sought to develop a probability-based differential diagnosis for Adolescent HMB, menorrhagia or abnormal uterine bleeding. Methods A comprehensive literature search was conducted using PubMed, EMBASE, and SCOPUS databases. Case series describing adolescents from 10–19 years of age with HMB, menorrhagia or abnormal uterine bleeding was acceptable if: more than 10 patients were included; editorials, case reports, and secondary sources such as review articles, or book chapters were excluded. No language filter was used, but an English abstract was required. The etiology of HMB, menorrhagia or abnormal uterine bleeding, and the country of origin was extracted from articles that met inclusion criteria. Cumulative rate estimates were determined by Bayesian probability modeling. Results Seventeen full text articles were reviewed in detail; 2,770 patients were included. The most frequent causes of HMB were Ovarian Uterine Disorders (23.7%; 95% CredI 22–25.5%), Coagulation Disorders (19.4%; 95% CredI 17.8—21.1%), and Platelet Disorders (6.23%; 95% CredI 5.27–7.27%) with 45.9% (95% CredI 43.8—47.%9) of the cases of indeterminate origin. Conclusions The leading causes of HMB in healthy adolescent females were varied. The sub-analysis identified distinct etiologies, suggesting that multiple factors must be considered in the evaluation of HMB. While PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified) provides us with a comprehensive picture of the possible causes of HMB in females, this systematic review assigns probabilities to the etiologies of HMB in adolescent females, providing physicians with a more focused and efficient pathway to diagnosis.

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Systematic Review and Meta-Analysis of the Etiology of Menorrhagia in 2,770 adolescent females

Hall,

Ravelo,

Aronoff

et al. 2023

Preprint

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Background: Adolescent menorrhagia, heavy menstrual bleeding, or abnormal uterine bleeding commonly occur in adolescent woman. The differential diagnosis can be challenging. The pneumonic: PALM-COEIN(polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified), is commonly used but it does not stratify as to the likelihood of a disorder. We have sought to develop a probability-based differential diagnosis for Adolescent menorrhagia, heavy menstrual bleeding, or abnormal uterine bleeding Methods: A comprehensive literature search was conducted using PubMed, EMBASE, and SCOPUS databases. Case series describing adolescents from 10 to 21 years of age with menorrhagia, abnormal uterine bleeding (AUB), or heavy menstrual bleeding (HMB) were acceptable if: more than 10 patients were included; editorials, case reports, and secondary sources such as review articles, or book chapters were excluded. No language filter was used, but an English abstract was required. The etiology of menorrhagia, abnormal uterine bleeding, or heavy menstrual bleeding, and the country of origin was extracted from articles that met inclusion criteria. Cumulative rate estimates were determined by Bayesian probability modeling. Results: 17 full text articles were reviewed in detail; 2,770 patients were included. The most frequent causes of menorrhagia were Ovarian Uterine Disorders (23.7%; 95% CredI 22-25.5%), Coagulation Disorders (19.4%; 95% CredI 17.8 - 21.1%), and Platelet Disorders (6.23%; 95% CredI 5.27-7.27%) with 45.9% (95% CredI 43.8 - 47.%9) of the cases of indeterminate origin. Conclusions: The leading causes of menorrhagia in healthy adolescent females were varied. The sub-analysis identified distinct etiologies, suggesting that multiple factors must be considered in the evaluation of menorrhagia. While PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified) provides us with a comprehensive picture of the possible causes of menorrhagia in females, this systematic review assigns probabilities to the etiologies of menorrhagia in adolescent females, providing physicians with a more focused and efficient pathway to diagnosis.

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Adolescent abnormal uterine bleeding – The PALM COEIN approach

Cited by 3 publications

References 31 publications

Menstrual Pattern Disorder Related to Physical Activity and Stress Psychic Soldiers Female Student of Indonesian Navy

Menstrual Pattern Disorder Related to Physical Activity and Stress Psychic Soldiers Female Student of Indonesian Navy

Systematic review and meta-analysis of the etiology of heavy menstrual bleeding in 2,770 adolescent females

Systematic Review and Meta-Analysis of the Etiology of Menorrhagia in 2,770 adolescent females

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