Types:

1. Acute: Sufficient in quantity to require immediate intervention to prevent further blood loss.
2. Chronic: Abnormal frequency, regularity, duration, and/or volume AND has been present for the past six months.

Etiology

Primary causes: high Progesterone

Secondary Causes: PALM-COEIN

PALM = STRUCTURAL

• Uterine Fibroid/Leiomyoma → most common cause
• Uterine Polps
• Adenomyosis
  • • Dysmenorrhea and Pelvic Pain (Female)
• Malignancy & Hyperplasia → Endometrial Cancer

COEIN = NONSTRUCTURAL

• Coagulopathy → Bleeding Disorders
• Ovulatory disorders
  • e.g. PCOS
• Endometrial (non-structural)
  • Diagnosis of exclusion, often associated with Dysmenorrhea
• Iatrogenic
  • Most often OCP