What treatment will you recommend for a 33-year-old woman who presents with heavy menstrual bleeding and on examination, is found to have a uterus that is approximately 8 weeks in... What treatment will you recommend for a 33-year-old woman who presents with heavy menstrual bleeding and on examination, is found to have a uterus that is approximately 8 weeks in size? An ultrasound scan shows two fibroids - one measuring 5 cm in diameter and causing a mild distortion of the endometrial cavity and the other a 3 cm intramural fibroid. Her Hb is 102 g/L.
Understand the Problem
The question is asking for a recommended treatment for a specific case of a 33-year-old woman with heavy menstrual bleeding due to uterine fibroids, taking into account her hemoglobin levels and ultrasound findings. It presents several treatment options and seeks the most appropriate one.
Answer
Medical therapy with GnRH agonists or myomectomy if fertility needs to be preserved.
The final answer is Medical therapy with GnRH agonists for reducing fibroid size and heavy bleeding, or myomectomy if fertility preservation is needed.
Answer for screen readers
The final answer is Medical therapy with GnRH agonists for reducing fibroid size and heavy bleeding, or myomectomy if fertility preservation is needed.
More Information
For a 33-year-old woman who might want to preserve fertility, myomectomy can be a viable option. GnRH agonists help in reducing fibroid size and controlling bleeding, which can be beneficial in managing symptoms non-surgically.
Tips
A common mistake is recommending major surgery like hysterectomy without considering the patient's age and desire to preserve fertility.
Sources
- Management of Uterine Fibroids - Effective Health Care Program - effectivehealthcare.ahrq.gov
- Uterine Fibroids: Diagnosis and Treatment - AAFP - aafp.org
- Uterine fibroids - Diagnosis and treatment - Mayo Clinic - mayoclinic.org
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