A 45-year-old female presents with polymenorrhoea for 6 months. On local examination nothing abnormal was seen. Which of the following is the best line of management
NOTE: dilatation and currettage is both therapeutic and diagnostic. Here the main idea of doing a currettage is to obtain a diagnosis in a case of perimenopausal abnormal uterine bleeding, since it is impoant here to rule out malignancy. To sta progesterones will be helpful for controlling bleeding since these are mostly safe,but for assessing the diagnosis and giving appropriate treatment , specifically for this age group , a curettage is the best possible option in this situation. In a 45 year old woman with irregular bleeding, could be due to many causes: 1. Anovulation with irregular bleed (Remember, ovulatory cycles are regular & anovulatory cycles are irregular) 2. Hyperplasias, with or without atypia 3. Endometrial or endocervical malignancies 4. Polyps in the uterus
Give progesterone for 3 cycles
Give OCP for 3 cycles
Dilation and curettage
Hysterectomy
Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception