What is the most likely diagnosis for a patient with an enlarged uterus, urinary frequency, and heavy menstrual bleeding?

The most likely diagnosis in this scenario is uterine fibroids, also known as leiomyomas. Uterine fibroids are benign tumors composed of smooth muscle and fibrous tissue and are commonly found in women of reproductive age.

The symptoms presented—enlarged uterus, urinary frequency, and heavy menstrual bleeding—are characteristic of uterine fibroids. The growth of these fibroids can cause the uterus to enlarge, leading to a feeling of fullness or an increase in abdominal girth. As fibroids grow, they can exert pressure on the bladder, resulting in urinary frequency or urgency. Additionally, fibroids are known to cause heavy menstrual bleeding due to their effect on the endometrial lining, increasing the volume of menstrual flow through various mechanisms, including disrupting normal contraction patterns during menstruation.

The other options do not align with all the symptoms as clearly. Adenomyosis, while it can also lead to an enlarged uterus and heavy bleeding, typically presents more with dysmenorrhea (painful periods) and may not specifically cause urinary frequency as prominently as fibroids. Ovarian neoplasms could lead to abdominal distension but are less commonly associated with heavy menstrual bleeding and urinary symptoms directly related to uterine size. Diverticular