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March 25, 2024

Maxine, a 31-year-old G0, is an established patient of your practice and presents today for a routine well woman exam

Maxine, a 31-year-old G0, is an established patient of your practice and presents today for a routine well woman exam. She was married 4 months ago after a short courtship with a family friend. She denies any complaints, however, you notice she is more withdrawn that usual and is not making eye contact with you. When asked about her menstrual cycle, she states her menses have been irregular over the past 3 months, skipping one month and bleeding twice the next month. Last period was 2 weeks ago and was a very heavy flow that, causing her to change tampons every hour on the first 2 days. She is not using any contraception because her husband wants a child right away.

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