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Heavy menstrual bleeding — MCCQE Part 1 MCQ

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EasyVaginal BleedingHeavy menstrual bleedingMCCQE Part 1

A 24-year-old woman has heavy regular periods lasting 8-10 days with large clots, every 28 days. Hb 95. No pregnancy desire. Normal pelvic exam and US. Most appropriate first-line management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Levonorgestrel IUS (Mirena)

HMB with anaemia: LNG-IUS is most effective first-line medical treatment (SOGC). Reduces blood loss by up to 97%. COCs and tranexamic acid are alternatives. Iron supplementation concurrently.

Reference: SOGC HMB Guideline