List two structural causes of AUB.

• A. Ovulatory dysfunction and coagulopathy
• B. Endometritis
• C. Pregnancy-related bleeding
• D. Polyps and leiomyoma

Answer: (D)

Structural abnormalities inside the uterus can cause abnormal uterine bleeding by creating local lesions or distortions that disrupt normal endometrial shedding. Polyps (endometrial polyps) and fibroids (leiomyomas) are classic examples of such structural problems. They are physical changes in the uterine lining or tissue that can lead to irregular, prolonged, or heavy bleeding, often independent of ovulation.

The other options point to causes that are not due to a discrete uterine structure: ovulatory dysfunction and coagulopathy are systemic factors that alter bleeding without a specific uterine lesion; endometritis is an infection/inflammation of the endometrium; pregnancy-related bleeding is a separate clinical scenario tied to pregnancy rather than a structural uterine lesion. Therefore, polyps and leiomyoma best fit the idea of two structural causes of AUB.