Question
A 34-year-old female with a history of abnormal uterine bleeding (AUB) and fibroids presents for treatment. After a review of her labs and imaging, and after a detailed discussion regarding treatment options, she reports she desires continued fertility and would like to explore non-hormonal options for her AUB. Which of the following therapies would be the best option for control of this patient’s abnormal uterine bleeding?
| A. | Tranexamic acid and NSAIDs |
| B. |
Levonorgestrel-releasing intrauterine device |
| C. |
Combination oral contraceptive pills |
| D. |
Depot-leuprolide injections |
Show Answer
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Correct Answer � A Explanation |
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Ans. A
Medical management can be used to control symptoms of AUB, even in women with fibroids. A detailed discussion with the patient is important to determine fertility desire, review goals and prognosis, and review medical comorbidities that might affect treatment options.
Tranexamic acid and NSAIDs remain the only non-hormonal treatment option.
Antifibrinolytics such as tranexamic acid, along with NSAIDs, can reduce menstrual blood loss by up to 50%.
In women desiring to conceive, tranexamic acid and NSAIDs remain a first-line option for treatment.