23rd December 2021

A 45-year-old primiparous lady presents with heavy menstrual bleeding and some pain around menstruation

A 45-year-old primiparous lady presents with heavy menstrual bleeding and some pain around menstruation. She reports that pain is more manageable with NSAIDS and does not report dyspareunia. She first noticed the increased bleeding when she was using sanitary products more frequently. She reports no fatigue or change in bowel habits or bladder function. She has a family history of heart problems, and is in good health herself, taking no medications. On examination, the abdomen is soft, non-tender with a suprapubic mass. What is the most likely diagnosis?

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