A 28-year-old nulligravid patient complains of bleeding between her periods and increasingly heavy menses. Over the past 9 months she has had two dilation and curettages (D&Cs), which have failed to resolve her symptoms, and oral contraceptives and antiprostaglandins have not decreased the abnormal bleeding. Which of the following options is most appropriate at this time?

a. Perform a hysterectomy

b. Perform hysteroscopy

c. Perform endometrial ablation

d. Treat with a GnRH agonist

e. Start the patient on a high-dose progestational agent

the answer is below…

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