This review highlights the difficulties currently caused by the ill-defined and confused use of terminologies to describe symptoms, signs and causes of abnormal uterine bleeding. It also attempts to put usage of modern terminologies in an historical context with important lessons for current usage.
Confused terminology has led to difficulties in interpreting the results of many clinical trials of new therapies and surgical procedures for abnormal uterine bleeding, and in understanding some studies investigating underlying mechanisms of bleeding. The confusion is so great that a major international expert group has recommended abolition of such terms as ‘menorrhagia’, ‘metrorrhagia’ and ‘dysfunctional uterine bleeding’, and replacement with much simpler terms to specifically cover cycle regularity, frequency, duration and heaviness of bleeding episodes, and to acknowledge a significant change in pattern for individual women. New terminologies are required to describe certain underlying causes of abnormal uterine bleeding.
Such discussion should be an ongoing process aimed towards good international agreement, which will greatly simplify the interpretation of clinical trials and scientific studies of mechanisms and treatment responses, and will contribute to the process of education at all levels.
aDepartment of Obstetrics and Gynaecology, University of Sydney, Australia
bSection of Obstetrics and Gynaecology, Department of Reproductive and Developmental Sciences, University of Edinburgh, UK
cDepartments of Obstetrics and Gynecology, University of California, Los Angeles, and Kaiser Permanente Southern California, Los Angeles Medical Center, Los Angeles, USA
Correspondence to Professor Ian S. Fraser, Department of Obstetrics and Gynaecology, Queen Elizabeth II Research Institute for Mothers and Infants, University of Sydney, NSW 2006, Australia Tel: +61 2 9351 2478; fax: +61 2 9351 4560; e-mail: email@example.com