In the PALM-COEIN framework, which is a structural etiology?

In the PALM-COEIN framework, which is a structural etiology?

• A. Coagulopathy
• B. Ovulatory dysfunction
• C. Iatrogenic factors
• D. Adenomyosis

Answer: (D)

In PALM-COEIN, structural etiologies are physical lesions or architectural problems within the uterus. Adenomyosis fits this category because it involves endometrial tissue existing within the myometrium, leading to a thickened, bulky uterus and often heavy or painful menses. This is different from non-structural factors like coagulopathy (a systemic bleeding tendency), ovulatory dysfunction (hormonal cycle irregularities), or iatrogenic causes (bleeding related to procedures or medications), which affect bleeding without a discrete uterine lesion. So adenomyosis is the structural etiology in this framework.

In PALM-COEIN, structural etiologies are physical lesions or architectural problems within the uterus. Adenomyosis fits this category because it involves endometrial tissue existing within the myometrium, leading to a thickened, bulky uterus and often heavy or painful menses. This is different from non-structural factors like coagulopathy (a systemic bleeding tendency), ovulatory dysfunction (hormonal cycle irregularities), or iatrogenic causes (bleeding related to procedures or medications), which affect bleeding without a discrete uterine lesion. So adenomyosis is the structural etiology in this framework.