Heavy Menstrual Bleeding

Question 1

INVESTIGATIONS:

Answer 1

History, Examination , FBC(for anaemia)

- further investigations for underlying pathology ie presenting with postcoital/intermenstrual bleeding

Question 2

MANAGEMENT

Answer 2

1. Requires ongoing contraception
   - 1st line: Levonorgestrel-releasing IUS
   - 2nd line: COCP
   - 3rd line: Long-acting progestogens(Depo-Provera)
2. Does not require ongoing contraception:
   - Tranexamic acid/NSAIDs(eg. mefenamic acid)