Question

33 yr old female with heavy menstrual bleeding for 6 months comes to the gynaecology OPD.On examination, no abnormality was seen.USG also appeared normal. The patient was tried to be managed on non-hormonal treatment but it failed. What will be the next management step ?

• A. Hormonal therapy
• B. Endometrial sampling
• C. Hysterectomy
• D. Hysterectomy

Answer 1

The Correct Option is B

In the scenario described, a 33-year-old female patient presents with heavy menstrual bleeding (HMB) for six months. Despite the absence of abnormalities noted in a physical examination and a normal ultrasound scan (USG), the patient's condition persists despite non-hormonal treatment attempts. The appropriate next step in management involves understanding and identifying potential underlying causes that have not been diagnosed through imaging or initial examination.

Given these circumstances, performing an endometrial sampling is the next logical step. This procedure is necessary to rule out any endometrial pathology, such as hyperplasia or malignancy, which could be causing the abnormal bleeding. Endometrial sampling provides histopathological data that can guide further treatment decisions, ensuring that any serious conditions are promptly identified and managed.

This step is crucial in precisely diagnosing the cause of HMB when non-invasive methods such as imaging have not offered conclusive results, and symptomatic treatment has not been effective.