Final answer:
Alternative treatments for anovulatory bleeding after the failure of OCP include the hormonal patch, IUDs, ovulation induction medications, addressing underlying conditions, tranexamic acid, NSAIDs, and as a last resort, surgical options for those not wishing to conceive.
Step-by-step explanation:
A 30-year-old patient with a history of anovulatory bleeding who has tried oral contraceptive pills (OCP) without success might consider exploring several other therapeutic options. Firstly, non-oral hormonal treatments such as the hormonal patch or hormonal intrauterine devices (IUDs) can be alternatives, offering similar hormonal regulation without the need for daily oral intake. Secondly, if the patient is seeking to conceive, fertility treatments such as ovulation induction with medications like clomiphene citrate or letrozole may be appropriate. Additionally, investigating and treating any underlying conditions, such as polycystic ovary syndrome (PCOS) or thyroid disorders, that could contribute to anovulation, is essential. If hormonal methods are not suitable, or if the patient prefers non-hormonal methods, tranexamic acid or non-steroidal anti-inflammatory drugs (NSAIDs) can be used during menstruation to reduce bleeding. In severe cases where medical management is not effective, surgical options like endometrial ablation or hysterectomy could be discussed, although these are generally last-resort measures for those not wishing to conceive in the future.