PALM: structural causes
Polyp (AUB-P)
Adenomyosis (AUB-A)
Leiomyoma (AUB-L)
Malignancy and hyperplasia (AUB-M)
COEIN: nonstructural causes
Coagulopathy (AUB-C)
Ovulatory dysfunction (AUB-O)
Endometrial (AUB-E)
Iatrogenic (AUB-I)
Not yet classified (AUB-N)
Polyp (AUB-P)
Adenomyosis (AUB-A)
Leiomyoma (AUB-L)
Malignancy and hyperplasia (AUB-M)
Coagulopathy (AUB-C)
Ovulatory dysfunction (AUB-O)
Endometrial (AUB-E)
Iatrogenic (AUB-I)
Not yet classified (AUB-N)

Age 12-18: most commonly immature hypothalamic-pituitary-ovarian axis, also consider<unk>  dyscrasia
Age 19-39: most commonly structural lesion (fibroid, polyp) or PCOS
Age 40+: most commonly endometrial atrophy, also consider malignancy especially in post-menopausal
Urine pregnancy
Complete blood count
Coags (if history of or suspect coagulopathy)
TSH, prolactin (if suspect endocrine disorder)
C. trachomatis and N. gonorrhoeae testing if risk of infection (consider with post-coital<unk> 
Consider follow up for non-emergent pelvic ultrasound
No indication for emergent ultrasound in ED
No indication for emergent ultrasound in ED
Hemodynamically stable patient in ED must rule-out:
Pregnancy
Trauma<unk>  dyscrasia
Infection
Retained vaginal foreign body
If work up negative, can refer for further outpatient work up
Pregnancy
Trauma<unk>  dyscrasia
Infection
Retained vaginal foreign body
If work up negative, can refer for further outpatient work up
Nonpregnant vaginal bleeding
Systemic Causes
Vaginal bleeding in pregnancy 
Cirrhosis
Prepubertal vaginal bleeding
Coagulopathy 
Abdominal pain in pregnancy
Group A strep vaginitis 