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A 34-year-old gravida 0 patient presents to your clinic with complaints of heavy menses and dysmenorrhea. She reports monthly periods lasting 10 days during which time she soaks overnight pads every 2 hours. She often passes large clots and has bled onto her sheets at night. She takes ibuprofen for cramping during her period and often misses work due to her symptoms. She has never been pregnant, but she and her partner would like to have children in the next few years. She denies other medical history and has never had surgery. She takes no medications besides ibuprofen and has no drug allergies. She states that she is a Jehovah’s Witness and does not accept blood products.
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