Question

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

Answer 1

The Correct Option is D

In dealing with a 45-year-old female patient who presents with 3 months of menorrhagia and an ultrasound showing a 2 cm submucosal fibroid, it is crucial to consider treatment options effectively. Menorrhagia due to fibroids can significantly impact a patient's quality of life, and submucosal fibroids are known to cause heavy bleeding because they protrude into the uterine cavity. Here are the treatment considerations:

• OCP for 3 months: Oral contraceptive pills (OCP) can be used to regulate menstrual cycles and reduce bleeding, but they might not effectively treat a fibroid of this type and size.
• Progesterone for 3 months: Progesterone therapy can also manage bleeding by thinning the endometrial lining, yet it does not address the fibroid itself, particularly submucosal fibroids that could persistently cause menorrhagia.
• Endometrial sampling: This diagnostic option can be helpful in determining if there is any other underlying pathology within the endometrium; however, it is not a treatment for fibroids.
• Hysterectomy: In a patient with completed childbearing or who does not desire future fertility, a hysterectomy represents a definitive treatment option. It effectively resolves the bleeding caused by the fibroid and removes the fibroid itself.

Considering the patient’s age, symptoms, and the desire for a definitive resolution of the fibroid problem, hysterectomy is the most appropriate treatment option.