Question:medium
A 45 years old female presents with 3 months of menorrhagia. USG shows a 2 cm submucosal fibroid. What are the treatment options?
A 45 years old female presents with 3 months of menorrhagia. USG shows a 2 cm submucosal fibroid. What are the treatment options?
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Perimenopausal woman with a structural fibroid - go definitive.
Updated On: Jun 23, 2026
- OCP for 3 months
- Progesterone for 3 months
- Endometrial sampling
- Hysterectomy
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: The patient is perimenopausal with heavy bleeding driven by a structural lesion - a 2 cm submucosal myoma. At this age and with a clear anatomical cause, definitive surgery is favoured over hormonal trials.
Step 2: Hysterectomy resolves both the bleeding and the fibroid in one definitive procedure and is the recommended option for symptomatic fibroids in an older woman who does not desire fertility.
Step 3: Combined OCPs or progestogens only temporise and cannot eliminate the fibroid, while endometrial sampling merely evaluates the lining rather than treating the cause. The decisive therapeutic choice is therefore hysterectomy.
\[\boxed{\text{Hysterectomy}}\]
Step 2: Hysterectomy resolves both the bleeding and the fibroid in one definitive procedure and is the recommended option for symptomatic fibroids in an older woman who does not desire fertility.
Step 3: Combined OCPs or progestogens only temporise and cannot eliminate the fibroid, while endometrial sampling merely evaluates the lining rather than treating the cause. The decisive therapeutic choice is therefore hysterectomy.
\[\boxed{\text{Hysterectomy}}\]
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