35 year old female G2P2 with no PMH reports dysmenorrhea and…
35 year old female G2P2 with no PMH reports dysmenorrhea and heavy menstrual bleeding. The patient reports her menstruation is regular, but premenstrual and menstrual symptoms have worsened in the last few months. The patient reports severe bloating before menstruation, menstrual cramps have become severe, and menstrual bleeding has become very heavy. She reports she needs to change her pads every 2-3 hours due to soaking through. LMP was 1 week ago. On exam, patient is in no distress. On pelvic exam: cervix is closed with no lesions, uterus non-tender, but slightly enlarged symmetrically; no adnexal masses, no pelvic motion tenderness. Otherwise, exam is unremarkable. VS: BP: 120/70 mmHg Rt arm sitting; HR:70 bpm, T: 98.6F oral, RR: 16 bpm unlabored. Please provide differential diagnosis for this presentation (list at least 5) AND what imaging would be indicated for this case.