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Whereas AUB is a collection of symptoms that include intermenstrual bleeding and abnormalities in period duration, cycle length, and regularity, it is heavy menstrual bleeding (HMB) that is most contributory to iron deficiency and related anemia. It is apparent that AUB, in general, and HMB, in particular, remain underrecognized and underreported. FIGO created two systems for assessing and classifying AUB. FIGO System 1 defines the bleeding pattern using four primary descriptors: frequency, duration, regularity, and flow volume. FIGO System 2 provides a structured classification system of possible causes of AUB, using the acronym PALM\u2010COEIN. \u201cPALM\u201d refers to structural causes of AUB (Polyp, Adenomyosis, Leiomyoma, Malignancy), and \u201cCOEI\u201d refers to nonstructural causes (Coagulopathy, Ovulatory dysfunction, Endometrial, and Iatrogenic). The \u201cN\u201d is reserved for those entities that are currently not otherwise classified. Using FIGO System 1 as a gateway to FIGO System 2 streamlines the investigation of reproductive\u2010aged women and girls with AUB. Understanding the pathogenesis of the FIGO System 2 \u201cPALM\u2010COEIN\u201d causes helps interpret investigations and the onward management of AUB. Numerous evidence gaps exist concerning AUB; however, if researchers and trialists universally adopt FIGO Systems 1 and 2 for the assessment and diagnosis of AUB, clear translatable research findings can be applied globally.<\/jats:p>","DOI":"10.1002\/ijgo.14946","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T03:17:19Z","timestamp":1691119039000},"page":"29-42","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":90,"title":["Contemporary evaluation of women and girls with abnormal uterine bleeding:\n                    <scp>FIGO<\/scp>\n                    Systems 1 and 2"],"prefix":"10.1002","volume":"162","author":[{"given":"Varsha","family":"Jain","sequence":"first","affiliation":[{"name":"Centre for Reproductive Health University of Edinburgh  Edinburgh, Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm G.","family":"Munro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary O. 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