Abstract / Summary
Background: Abnormal uterine bleeding (AUB) is a frequent gynecological disorder affecting women of reproductive age and beyond. It presents as irregular, heavy, or prolonged bleeding, negatively impacting the quality of life for a significant proportion of women globally. The FIGO PALM-COEIN classification facilitates the distinction between structural and non-structural etiologies of AUB, supporting evidence-based management strategies. Objective: To analyze the pharmacological treatments, causative factors, risk profile, and management approaches for AUB in women attending the Obstetrics and Gynecology Department at MIMS Tertiary Care Hospital, Mandya. Methodology: This prospective crosssectional observational study enrolled 172 women aged 18—50 years who presented with AUB. Patient demographic information, menstrual history, comorbidities, structural findings (via USG and PALM-COEIN classification), diagnostic modalities, and treatment regimens were systematically recorded and analyzed utilizing descriptive statistics and a structured patient profile format. Results: Women aged 39—50 years comprised the majority of cases (51%), with irregular heavy bleeding being reported by 76.2%, frequently accompanied by pelvic pain and dysmenorrhea (55.2%). Thyroid disorders were the predominant comorbidity (87%), followed by PCOS (7%) and diabetes (3%). Structural etiologies determined using PALM-COEIN classification revealed leiomyoma as the leading cause (54.7%), with polyp (19.8%), adenomyosis (15.1%), and endometriosis (10.5%) also commonly seen. Most cases (64%) were managed surgically, while 36% received medical treatment. Meprate (48.4%) and Regesterone (33.9%) were the preferred oral hormonal agents, both representing progestin therapy. Paracetamol was the most commonly prescribed analgesic (51.9%), and Tranexamic acid (53%) was slightly favored over Mefenamic acid (47%) for antifibrinolytic intervention. Postoperative support centered on iron and vitamin supplementation, with Metronidazole and Ceftriaxone as the primary antibiotic regimen. Conclusion: AUB most often affects middleaged women, manifesting with irregular heavy bleeding and thyroid gland dysfunction as the most frequent comorbidity. Leiomyoma remains the principal structural cause. Surgical management predominates, while rational, individualized medical therapy supports comprehensive, patient-centered care. Early diagnosis and tailored treatment improve outcomes in AUB