Intermenstrual Spotting in Obstetrics & Gynecology — 46yo Woman | General Gynecology | SMLE Q#18405
SMLE Question #18405
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 46-year-old woman requests contraception. For 6 months, she has heavier menses with intermenstrual spotting. She has no pelvic pain, postcoital bleeding, or vaginal discharge. A urine pregnancy test is negative, and she has no symptoms of thyroid disease. Before prescribing contraception, which investigation is most appropriate to evaluate her bleeding?
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