A 49-year-old woman presents with heavy, irregular menstrual bleeding over the past 6 months. She is perimenopausal, haemoglobin is 110 g/L and pregna...

Question

A 49-year-old woman presents with heavy, irregular menstrual bleeding over the past 6 months. She is perimenopausal, haemoglobin is 110 g/L and pregnancy test is negative. Pelvic examination is normal. What is the most appropriate initial investigation?

Accepted Answer

Transvaginal pelvic ultrasound

Answer

Start combined oral contraceptive pill without investigations

Answer

FSH and LH levels to confirm perimenopause

Answer

Endometrial biopsy in all women under 50

Answer

MRI pelvis

ca-mccqe1 MCQ (SBA): Abnormal uterine bleeding

A 49-year-old woman presents with heavy, irregular menstrual bleeding over the past 6 months. She is perimenopausal, haemoglobin is 110 g/L and pregnancy test is negative. Pelvic examination is normal. What is the most appropriate initial investigation?