45 years female with 3 months
menorrhagia. USG showing 2 cm
submucosal fibroid.Treatment options.
a) Ocp for 3 months
b) Progesterone for 3 months
c) Endometrial sampling
d) Hysterectomy
Correct Answer - D
Ans. D. Hysterectomy
YOUNG WOMEN OLDER WOMEN
Contraception
not desirable
Contraception desired
Combined OCPs
Progestogens and other
hormones
Mirena
Rule out cancer &uterine
pathology
Progestogens
Ethamsylate,
NSAIDs
Estrogen
Tranexamic for
3–4 months
GnRH 3–4
months
Effective Fails Normal uterus
(DUB)
Uterine
pathology
Continue
for 6–9
months
Minimal
invasive
surgery
Hysterectomy
with
conservation
of ovaries
Progestogens
and others
?No response
Hysterectomy
with removal of
ovaries after 50
years
Surgery
Removal of an intrauterine contraceptive device if medical therapy
fails.
Myomectomy/hysterectomy for uterine fibroids.
Wedge resection/hysterectomy for adenomyosis of the uterus.
Dilatation and curettage with blood transfusion is the primary
treatment of puberty menorrhagia with low Hb%
Multipara, hypertensive woman with menorrhagia should be treated
with MIRENA
Hysterectomy with or without removal of the adnexa according to the
age and the individual needs of the patient.