FIGO Classification of Abnormal Uterine Bleeding

The International federation of Obstetrics and Gynecology has some pretty detailed stagings of gynecological cancers. They keep modifying these periodically. I had not thought they would go beyond that, but they did. I came across their classification of abnormal uterine bleeding (AUB) on the internet. Surprisingly it has not found its place in text books of Gynecology. I also found out that hardly anyone knew about it, though it came out in 2011. I tried to find out why. There were several reasons.

1. They had done away with the age old terminology of menorrhagia, polymenorrhea, oligomenorrhea, metrorrhagia, hypomenorrhea, cryptomenorrhea etc, and replaced them with descriptive terms. The old terms were fine, brief, precise and well accepted. They caused no confusion and there was no need to change them.
2. They had left things half way. While leiomyomas had been subclassified a lot, other lesions like polyps, adenomyosis had not been subclassified at all.
3. They had pooled endometrial hyperplasia and malignancy together. Putting benign and malignant conditions of the uterus together made no sense.
4. They had scrapped the term 'dysfunctional uterine bleeding' which was quite satisfactory.
5. The purpose of this new classification was not clear. No purpose seems to have been served in the two years after they put out the classification.
6. They put one condition - iatrogenic - in the list. They did not put any in which the patient ingested hormones on her own and caused abnormal uterine bleeding.
7. They put a 'not yet classified' category. If they brainstormed and came up with a whole new classification which was to replace the old one, the new one had to be comprehensive. Leaving a big unclassified chunk does not make sense.

"Why have they done this?" someone asked me.
"To justify their existence?" someone else suggested. That sounded like justifying a trip to the city of the meeting, all expenses paid.
"To feel good at having created something new?" a third person suggested.
"To provide material for newer editions of textbooks?" someone snickered.
"I found the following explanation on the internet" I said. "These are quotes of the committee members.

1. There has been general inconsistency in the nomenclature used to describe ...AUB in reproductive aged women, and there is a plethora of potential causes—several of which may coexist in a given individual.
2. It seems clear that the development of consistent and universally accepted nomenclature is a step toward rectifying this unsatisfactory circumstance. Another requirement is the development of a classification system for the causes of AUB, which can be used by clinicians, investigators, and even patients themselves to facilitate communication, clinical care, and research.
3. The goal of our panel was to develop an agreed pragmatic classification system with a standardized nomenclature to be used worldwide by researchers and clinicians investigating and treating women of reproductive age with AUB."

 They all were stunned.
"What does it all mean?" the first person asked.
"Does it mean anything?" the second person asked.
"It all reminds me of the preventive and social medicine text books. A lot of words, and you are blank after reading them" the third person said. I neither agreed nor disagreed with any comment.
"The concluding remarks included this line" I said. "We recommend a scheduled systematic review of the system on a regular basis by a permanent committee of an international organization such as FIGO."
"Now we know what it is all about" they said and laughed.