Which of the following is a structural cause of AUB?

• A. Polyps
• B. Coagulopathy
• C. Ovulatory dysfunction
• D. Not yet classified

Answer: (B)

The key idea is distinguishing structural from non-structural causes of abnormal uterine bleeding. Structural causes are physical changes in the uterus that affect the lining or cavity—things like polyps, adenomyosis, fibroids (leiomyomas), or malignancy/hyperplasia. Coagulopathy, on the other hand, is a non-structural issue: it’s a systemic problem with blood clotting that leads to heavier or more prolonged bleeding without a change in the uterine structure. Ovulatory dysfunction is also non-structural, tied to hormonal regulation of the cycle rather than a physical lesion.

Polyp fits as a structural cause because it is a growth originating from the endometrium that protrudes into the uterine cavity and can cause irregular or prolonged bleeding due to localized surface changes. Coagulopathy does not involve a structural lesion, so it’s not the correct structural answer.