44-year-old Multiparous in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#1635

SMLE Question #1635

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 44-year-old multiparous woman has 1 year of progressively worsening dysmenorrhea and heavy regular menses. She reports soaking pads every 1–2 hours on the heaviest days. She has no history of pelvic inflammatory disease. Pelvic examination shows a diffusely enlarged, tender uterus without discrete palpable masses. Endometrial biopsy shows proliferative endometrium without hyperplasia or malignancy. What is the most likely diagnosis?

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