Management of Abnormal Uterine Bleeding Among Reproductive Age Group Women: A Cross-Sectional Study

Abstract

Background: Abnormal uterine bleeding (AUB) is a common gynecological complaint affecting women of reproductive age. This study aimed to explore the management of AUB using the FIGO PALM-COEIN classification system. Methods: A cross-sectional study was conducted at King Abdullah bin Abdulaziz University Hospital, reviewing 500 medical records of women aged 20–50 years with AUB. Data on demographics, clinical characteristics, PALM-COEIN classification, and treatment modalities were collected and analyzed. Results: The majority of participants were aged 20–29 years (43%) and overweight or obese (64.2%). Ovulatory dysfunction (31.6%) was the most common identifiable cause of AUB, followed by leiomyoma (16.8%). Hormonal treatments, particularly combined oral contraceptive pills, were associated with improved outcomes (OR = 2.15, p < 0.001) and reduced anemia prevalence (p = 0.042). Age (OR = 0.95, p = 0.015) and BMI (OR = 1.10, p = 0.005) were significant predictors of treatment response. The presence of leiomyoma decreased the odds of treatment success (OR = 0.55, p = 0.007), while ovulatory dysfunction increased the likelihood of response (OR = 1.75, p = 0.003). Conclusions: The study highlights the complex nature of AUB and the effectiveness of hormonal treatments in its management. Findings emphasize the need for individualized treatment approaches based on the underlying etiology and patient characteristics. Future research should focus on long-term outcomes and optimizing management strategies for complex cases.