Managing Abnormal Uterine Bleeding in Non-Pregnant Patients: Insights from Dr. Mahino Talib

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In this episode of Core EM, the host discusses managing vaginal bleeding in non-pregnant patients with Dr. Mahino Talib, an associate professor of OB-GYN at NYU. The conversation covers the updated terminology for abnormal uterine bleeding (AUB) and breaks down its structural and non-structural causes using the PALM-COEIN acronym.

Dr. Talib provides insights into the differential diagnosis and specific interventions that can be performed in an ER setting, including the use of progestin treatments, birth control tapers for younger patients, and high-dose IV estrogen for heavy bleeding. She emphasizes the importance of differentiating between structural and non-structural causes and tailoring treatment plans based on the patient's age, comorbidities, and bleeding severity.

Episode Breakdown:
00:00 Introduction to Vaginal Bleeding in Non-Pregnant Patients
01:01 Understanding Abnormal Uterine Bleeding (AUB)
01:57 Differential Diagnosis: Structural vs. Non-Structural Causes
02:50 Structural Causes of AUB: Polyps, Adenomyosis, Fibroids, and Malignancy
05:29 Non-Structural Causes of AUB: Coagulopathy, Ovulatory Dysfunction, and More
13:15 ER Workup and Management of Stable Patients
19:14 Managing Heavy Bleeding in the ER
24:57 Conclusion and Final Thoughts

Host: Avir Mitra MD
Instagram: @avirmitra
TikTok: @avirmitramd

About the Guest:
Dr. Mahino Talib is a clinical associate professor in the department of obstetrics and gynecology at NYU Grossman School of Medicine, and the associate director in the clerkship program in OB-GYN.

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This video was made possible through the support of NYU School of Medicine’s interdisciplinary curriculum initiative, Critical Diagnoses (CxDx). Production by Alyscia Batista, Leo Nachamie, and the Core EM team.

#VaginalBleeding #AbnormalUterineBleeding #AUB #EmergencyMedicine #CoreEM #NYULangone #CriticalDiagnoses

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