Clinical Intake — Leiomyoma of uterus

A 47-year-old female presents with a 12-month history of symptomatic uterine fibroids, the largest measuring 4.8 cm, causing debilitating menorrhagia with clot passage and significant pelvic pressure. Workup confirms chronic iron deficiency anemia with hemoglobin of 10.2 g/dL and hematocrit of 31.4%, attributed to ongoing blood loss. Conservative measures including NSAIDs, antifibrinolytic therapy, and hormonal IUD placement have each been trialed and failed — the IUD spontaneously expelled at 12 weeks due to fibroid distortion of the uterine cavity. Endometrial biopsy and cervical cytology are both benign. The patient has completed childbearing and, following thorough counseling on all available options, Dr. Chen refers her for definitive surgical management.