Which statement correctly describes the PALM-COEIN framework?

Which statement correctly describes the PALM-COEIN framework?

• A. PALM refers to structural etiologies, COEIN to non-structural etiologies
• B. PALM and COEIN are both structural
• C. PALM-COEIN only applies to postmenopausal bleeding
• D. PALM-COEIN excludes malignancy

Answer: (A)

The main idea is that abnormal uterine bleeding is categorized by whether there is a discrete structural lesion. PALM covers structural etiologies such as polyps, adenomyosis, leiomyomas (fibroids), and malignancy or hyperplasia. COEIN covers non-structural etiologies, including coagulopathy, ovulatory dysfunction, endometrial factors not forming a discrete lesion, iatrogenic causes, and conditions not yet classified. Therefore, saying that PALM refers to structural etiologies and COEIN to non-structural etiologies is correct. It’s also important to remember that malignancy is included under PALM, not excluded, and the framework applies to abnormal uterine bleeding beyond just postmenopausal cases.

The main idea is that abnormal uterine bleeding is categorized by whether there is a discrete structural lesion. PALM covers structural etiologies such as polyps, adenomyosis, leiomyomas (fibroids), and malignancy or hyperplasia. COEIN covers non-structural etiologies, including coagulopathy, ovulatory dysfunction, endometrial factors not forming a discrete lesion, iatrogenic causes, and conditions not yet classified. Therefore, saying that PALM refers to structural etiologies and COEIN to non-structural etiologies is correct. It’s also important to remember that malignancy is included under PALM, not excluded, and the framework applies to abnormal uterine bleeding beyond just postmenopausal cases.