Osteopathic Commentary and Perspective  |  OC1001

An Osteopathic Commentary on Diagnosis of Abnormal Uterine Bleeding in Reproductive-Aged Women

Based on ACOG Practice Bulletin No. 128

About this Activity

This free CME activity is exclusively available to members of the American College of Osteopathic Obstetricians and Gynecologists.

Abnormal uterine bleeding (AUB) affects approximately one-third of women who present for gynecologic evaluation and accounts for the majority of gynecologic consultations in the perimenopausal years. Despite its prevalence, diagnostic approaches have historically suffered from inconsistent terminology and fragmented evaluation pathways.

This activity applies an osteopathic perspective to the diagnosis of AUB in reproductive-aged women, building on the clinical framework established in ACOG Practice Bulletin No. 128 and the FIGO PALM–COEIN classification system. The osteopathic approach enriches the diagnostic evaluation by emphasizing whole-person assessment, structure-function relationships within the pelvis and its autonomic innervation, and patient-centered communication that integrates psychosocial and somatic dimensions of menstrual health.

For the practicing DO, this commentary provides a framework for applying osteopathic tenets to AUB evaluation, identifies opportunities for osteopathic manipulative treatment (OMT) as an adjunctive modality for related somatic dysfunction, and addresses equity and access considerations in rural and underserved practice settings.

Requirements

• ✓Complete the pre-test
• ✓Read the commentary in its entirety
• ✓Complete the post-test (scoring 75% or more) and the evaluation
• ✓Claim credit

Your certificate will be available in the ACOOG learning center under Transcripts after you complete the post-test and evaluation.

Learning Objectives

After completing this activity, the learner will be able to:

• ✓Describe the PALM–COEIN classification system for AUB and apply it within an osteopathic clinical framework that integrates somatic, visceral, and psychosocial assessment.
• ✓Identify how the four osteopathic tenets reframe the diagnostic evaluation of AUB, with emphasis on structure-function relationships and the body’s capacity for self-regulation.
• ✓Apply evidence-based osteopathic manipulative treatment (OMT) techniques as adjunctive interventions for somatic dysfunctions associated with AUB presentations.
• ✓Differentiate practice considerations for AUB evaluation across special populations, including adolescents, perimenopausal women, and patients in rural or underserved settings.

Author

Dina Gottesman, DO, FACOOG

Obstetrician and Gynecologist, Saint Peter’s Health Partners, Capital District, Albany, New York

Accreditation & Designation

CME Accreditation:
The American College of Osteopathic Obstetricians and Gynecologists (ACOOG) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians.

ACOOG is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Credit Designation:
ACOOG designates this enduring material for a maximum of 1.00 AOA Category 1-B credit and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.

ACOOG designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACOG Cognate Credit(s):
ACOOG designates this activity for Category 1 College Cognate Credits. Maximum Cognates are equal to the number of maximum AMA PRA Category 1 Credits™. A reciprocity agreement with the AMA exists that allows AMA PRA Category 1 Credits™ to be equivalent to ACOG Cognate Credits.

NPs, PAs & CNMs:
The AANPCB, NCCPA, and the American Midwifery Certification Board accept AMA PRA Category 1 Credits™ for certification and renewal requirements. ACOOG strongly recommends all non-physician health professionals check with their certification/licensing organizations to confirm credit reciprocity.

Disclosures

ACOOG requires each planner and author to identify all financial relationships with ineligible companies and mitigates risk of bias using a series of strategies for relevant relationships. Unless otherwise noted below, ACOOG, ACOOG staff, and planners for this activity have no relevant financial relationships to disclose.

Dr. Gottesman has no relevant relationship with an ineligible company to disclose.

Policies

Grievances: Any registrant finding evidence that the continuing medical education activity presented is inappropriate with regard to facilities, materials, content, or who observes any unacceptable promotion by a commercial interest may submit a grievance in writing to ACOOG, PO Box 17598, Fort Worth, TX 76102. Unresolved issues regarding this activity will require a formal written complaint to the AOA Division of CME, 142 East Ontario Street, Chicago, IL 60611.

Privacy Policy: This activity complies with ACOOG’s privacy policies.

Data Use: Data collected as part of this activity may be analyzed as part of educational research to study the effectiveness of educational interventions on health care, population health, health care providers and others, or to identify additional needs and gaps for future interventions.

Refunds: Refunds are not available for this educational product.

Disclaimer

This activity is offered by ACOOG for educational purposes only. Every patient case is different, and physicians must rely on their medical knowledge, experience, and relationships with patients to make clinical decisions.

This commentary is an independent work and is not affiliated with, endorsed by, or produced in collaboration with the American College of Obstetricians and Gynecologists (ACOG) or the authors of Practice Bulletin No. 128.