A 17-year-old female reports heavy menstrual bleeding characterized by the passage of “clots.” Her current menstrual period

A 17-year-old female reports heavy menstrual bleeding characterized by the passage of “clots.” Her current menstrual period has lasted 9 days. Her last menstrual period was 3 months ago. Menarche was at age 15, and she has no significant past medical history. On examination, she is afebrile, blood pressure is 110/70, BMI is 33, and abdomen soft and non-tender without palpable masses. Pelvic exam reveals no external abnormalities. Her cervix is nulliparous, and bimanual examination reveals an anteverted uterus of normal size without adnexal masses or tenderness. Laboratory studies reveal a hemoglobin of 10.4 g/dL and hematocrit of 31.2%. Which of the following is accurate concerning this case? A. Von WIllebrand is the most common cause of heavy menstrual bleeding in adolescents. B. Patient is experiencing menorrhagia. C. ACOG recommends endometrial tissue assessment to rule out cancer in all adolescents with anovulatory bleeding. D. The patient is probably experiencing anovulatory bleeding.

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