The FIGO Recommendations on Terminologies and Definitions for Normal and Abnormal Uterine Bleeding

Ian S. Fraser, M.D.; Hilary O.D. Critchley, M.D.; Michael Broder, M.D.; Malcolm G. Munro, M.D.

Disclosures

Semin Reprod Med. 2011;29(5):383-390. 

In This Article

Recommendations on Terminologies

Terminologies That Should Be Discarded

Extensive international discussions have strongly recommended that certain terminologies be abandoned because of their controversial, confusing, and poorly defined usage (Table 1).[2–4] These terminologies particularly include several English-language terms with Latin and Greek origins:

  • "Menorrhagia" is confusingly used as a symptom and diagnosis.

  • "Metrorrhagia" is poorly defined.

  • Most other terms of Latin and Greek origin are recommended to be abandoned as listed in Table 1.

A further term strongly recommended to be abandoned is dysfunctional uterine bleeding (DUB), which was first used in 1935, never clearly defined,[4] and is variably used as a symptom and a diagnosis.[2–4] It has mostly been used as a diagnosis of exclusion where the underlying pathology has not been defined, but these underlying mechanisms are being increasingly researched and defined.[10] Hence it is now recommended that the diagnoses encompassed within dysfunctional uterine bleeding can be classified[11] under three definable headings: (1) disorders of endometrial origin (disturbances of the molecular mechanisms responsible for regulation of the volume of blood lost at menstruation); (2) disorders of the hypothalamic-pituitary-ovarian axis; and (3) disorders of hemostasis (the "coagulopathies"). These three groups of diagnoses are sometimes referred to as "nonstructural" causes of abnormal uterine bleeding (AUB).[12]

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