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MediumO&GHeavy Menstrual Bleedingukmlamrcgp aktpanemrcem sbamrcp part 1prescribing safety assessment

A 40-year-old woman presents with heavy menstrual bleeding, reporting flooding and clots, impacting her quality of life. She is otherwise well. Examination is unremarkable. Initial blood tests show Hb 105 g/L, MCV 75 fL, Ferritin 8 µg/L. Coagulation screen is normal. Ultrasound scan shows a normal uterus and ovaries. According to NICE guidelines, what is the most appropriate first-line pharmacological treatment, assuming contraception is not required?

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