Which gynecologic history item is most relevant to evaluating heavy menstrual bleeding?

• A. Endometriosis
• B. PCOS
• C. Fibroids
• D. Prior cesarean section

Answer: (C)

Heavy menstrual bleeding is most often tied to a problem inside the uterus that increases blood loss. Uterine fibroids are a common benign tumor that can enlarge and distort the uterine cavity, increasing the endometrial surface area that sheds each cycle and altering blood flow. This frequently presents as prolonged periods, soaking through pads or tampons, and clots, making a history of fibroids the most relevant for evaluating heavy menses.

Endometriosis mainly causes painful periods and pelvic pain rather than heavy bleeding. PCOS tends to cause irregular or infrequent menses due to anovulation, not consistently heavy flow. A prior cesarean section has no direct link to heavy menstrual bleeding.