46 year-old Kathy is complaining of “heavy periods that are painful

46 year-old Kathy is complaining of “heavy periods that are painful.” She states for the past six months, her periods have become longer in duration. Kathy was alarmed this past month on days 2 and 3 of her period as she passed several clots and soaked three super absorbent pads in 2 hours. She does have a family history of fibroids and occasionally takes naproxen for the pain, which she finds does help somewhat.

1. What pathophysiological concepts must be considered to manage Kathy’s situation effectively?

2. Kathy asks whether she will have to get a hysterectomy like her mother did. What must be considered before you respond to this question?

3. What treatment options have you seen in practice for this disorder?