Question:
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
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The Correct Option is D
Solution and Explanation
Step 1: This is a 45 year old woman (perimenopausal, older age group) with menorrhagia caused by a documented submucosal uterine fibroid. Management in older women differs from young women and leans toward definitive treatment once malignancy is excluded and family is complete.
Step 2: For a symptomatic fibroid causing menorrhagia where conservation is not a priority, hysterectomy (with or without removal of the adnexa according to age and patient needs) is the definitive surgical treatment. Myomectomy or hysterectomy is appropriate for uterine fibroids.
Step 3: OCPs or progesterone for 3 months are medical options better suited to younger women or temporising measures and will not cure a structural submucosal fibroid. Endometrial sampling is a diagnostic step, not a treatment. Hence hysterectomy is the best treatment option here.
Step 2: For a symptomatic fibroid causing menorrhagia where conservation is not a priority, hysterectomy (with or without removal of the adnexa according to age and patient needs) is the definitive surgical treatment. Myomectomy or hysterectomy is appropriate for uterine fibroids.
Step 3: OCPs or progesterone for 3 months are medical options better suited to younger women or temporising measures and will not cure a structural submucosal fibroid. Endometrial sampling is a diagnostic step, not a treatment. Hence hysterectomy is the best treatment option here.
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