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.
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Given her symptoms and preferences, an NSAID would be the best first line treatment for this patient. True or false?
If she had already been taking an NSAID prior to presentation, tranexamic acid could be added as an adjunct. True or false?
This patient should have an ultrasound pelvis arranged prior to beginning medical treatment. True or false?
