23rd December 2021

A 36-year-old nulliparous woman presents to her GP with heavy menstrual bleeding. She is not experiencing any increased pain around menstruation

A 36-year-old nulliparous woman presents to her GP with heavy menstrual bleeding. She is not experiencing any increased pain around menstruation, nor any abnormal vaginal bleeding outside of her periods. There is no bladder or bowel dysfunction to report. She is otherwise well and taking no medications. On examination, the abdomen is soft and non-tender. There is a small, firm, suprapubic mass on palpation.

What is the most appropriate initial management for heavy menstrual bleeding?

Select the SINGLE most appropriate option from the list below. Select ONE option only.