Menstruation

Question 1

on what day does ovulation occur

Answer 1

day 14

Question 2

how long does “normal” cycle last

Answer 2

24-38 days

Question 3

surgical management of heavy menstrual bleeding

Answer 3

Polypectomy
Endometrial ablation
Uterine artery embolization
Myomectomy
Hysterectomy

Question 4

causes of heavy menstrual bleeding

Answer 4

fibroids (20-30%)
polyps (5-10%)
Adenomyosis (5%)
Coagulopathy (most common is von willebrand disease)
Malignancy

Question 5

first line management for heavy menstrual bleeding

Answer 5

mirena coil (levonorgestral-releasing intrauterine system, LNG-IUS)

Question 6

second line management for heavy menstrual bleeding

Answer 6

tranexamic acid, COC (combined oral contraceptive)

Question 7

3rd line management for heavy menstrual bleeding

Answer 7

progesterone only (oral norethisterone, depo or implant)