A 40-year-old nulligravid woman presents to the office for management of abnormal uterine bleeding. She reports a four-year history of heavy menses, which often lasts for two weeks in length and requires at least 10 sanitary pads per day. She denies abdominal pain or associated dizziness during menses. She reports prior use of multiple hormonal medications, including oral medroxyprogesterone and combined oral contraceptive pills, without improvement in her bleeding patterns. She is not currently taking any medications other than over-the-counter ferrous sulfate. Her past medical history is significant for iron deficiency anemia. She denies any surgical history. She has no plans for future fertility and would like definitive surgical management. When signing the surgical consent, she refuses transfusion of blood products.