Clinical case 2

A 34-year-old woman attends ED complaining of heavy menstrual bleeding. She is using 12 sanitary pads per day and often misses work when she is menstruating. She also suffers terrible cramping with her period. She has no other symptoms, no relevant history and is well between periods. Her smears are up to date. She is haemodynamically stable and examination is normal. She plans to try conceive in the next year or two, so she would rather avoid hormonal treatments if possible.