Gynecology Update
Evidence-based Recommendations for Abnormal Uterine Bleeding: Hysterectomy versus Alternative Therapy

 Harmanli O; Wheeler TL; Matteson KA; Abed H; Sung VW; Rahn DD; Schaffer JI; Uhlig K; Balk EM


 A 42-year-old woman, para 2, with a history of sterilization, is frustrated with her heavy and prolonged menstrual periods. She is having difficulty maintaining her active lifestyle. She finally decides to see her gynecologist. Her work-up, which includes a complete blood count, a Pap smear, an endometrial biopsy, and transvaginal ultrasonography, did not reveal anemia or any abnormal findings. Several oral contraceptives and hormonal combinations have failed to normalize her menstrual pattern. She was offered hysterectomy by her gynecologist. She is here now for a second opinion because she heard that there were affective alternatives to hysterectomy. 


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