Clinical Pathways
Clinical Pathways
Abnormal Uterine Bleeding, Nonpregnant
Abnormal Uterine Bleeding, Nonpregnant

Abnormal Uterine Bleeding, Nonpregnant

Tags
Emerg. Med. Practice
Published
August 1, 2021
Author(s)
Tazeen Abbas, MD; Abbas Husain, MD, FACEP

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Action

Patient presents with vaginal bleeding and a negative pregnancy test.

Decision

Is the patient hemodynamically stable or unstable?

Background

Differential diagnosis

The differential diagnosis of abnormal uterine bleeding (AUB) in nonpregnant women is broad and includes benign causes such as weight changes or stress, as well as life-threatening causes such as malignancy or trauma. AUB can also mimic bleeding from the genitourinary tract or gastrointestinal tract, so bleeding from extrauterine sources should always be considered.

Age 12-18 years

  • immaturity of the hypothalamic-pituitary-ovarian axis (most common)10^{10}
  • sexually transmitted infections
  • coagulopathies
  • bleeding disorders

Age 19-39

  • structural causes, including polyps, fibroids, and malignancy
  • polycystic ovarian syndrome (PCOS)

Age 40+

  • endometrial atrophy
  • cancer

‣
References
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Full Abnormal Uterine Bleeding Pathway
Full Abnormal Uterine Bleeding Pathway
Hemodynamically stable
Hemodynamically stable
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Hemodynamically unstable

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