Slowing the Flow: Management of Benign Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB), specifically heavy menstrual bleeding, is a common condition that can significantly affect women’s lives. AUB can impact women’s health, finances, social engagement, and overall quality of life. Potential causes of AUB can be assessed using a standard mnemonic to identify the origin as structural or nonstructural. The PALM-COEIN mnemonic stands for polyps, adenomyosis, leiomyoma, malignancy, hyperplasia, coagulopathy, ovulatory dysfunction, endometrial disorders, iatrogenic causes, and those not yet classified that are rare or not clearly defined. Treatment options include medical therapies, procedures, or surgical interventions. Nurse practitioners should partner with patients to individualize their plan of care based on best practices, beginning with the least invasive method. This case challenge highlights an underused treatment option for premenopausal women with heavy menstrual bleeding.