Risk Factors for Abnormal Uterine Bleeding
No, increased parity, dysmenorrhea, and history of tubectomy are NOT established risk factors for abnormal uterine bleeding (AUB) based on current evidence.
Understanding AUB Risk Factors
The provided evidence does not identify parity, dysmenorrhea, or tubectomy as risk factors for AUB. Instead, the literature focuses on a systematic classification of AUB causes rather than demographic or procedural risk factors 1, 2.
What Actually Causes AUB
The PALM-COEIN classification system categorizes AUB etiologies into:
Structural causes (PALM):
Non-structural causes (COEIN):
- Coagulopathy (especially von Willebrand disease)
- Ovulatory dysfunction (such as polycystic ovaries)
- Endometrial disorders
- Iatrogenic causes (including IUDs, corticosteroids, antipsychotic or antiepileptic drugs)
- Not yet classified 1, 2, 4
Actual Risk Factors Identified in Evidence
Age-related factors:
- Structural causes of uterine bleeding increase as women age 4
- Women older than 45 years require endometrial biopsy due to increased endometrial cancer risk 1
Systemic conditions:
- Thyroid disease
- Uncontrolled diabetes
- Obesity
- Blood coagulation disorders
- Psychological stress 4
Important Caveats
Dysmenorrhea is a symptom, not a risk factor - it may coexist with conditions causing AUB (like adenomyosis or fibroids) but does not independently predict AUB 5.
Parity and tubectomy are not mentioned in any of the contemporary classification systems or evaluation frameworks for AUB 1, 2, 3. The prevalence of AUB is estimated at 35% or higher in the general population, without stratification by parity or surgical history 1.