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Heavy menstrual bleeding — DRCOG MCQ

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HardGynaecologyHeavy menstrual bleedingDRCOG

A 39-year-old has heavy regular periods, normal examination, no intermenstrual bleeding or pressure symptoms, and also wants contraception. Which first treatment should be offered?

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Correct answer: A — A levonorgestrel-releasing intrauterine system

The best answer is “A levonorgestrel-releasing intrauterine system”. NICE recommends an LNG-IUS first for heavy menstrual bleeding when there is no identified pathology, fibroids under 3 cm that do not distort the cavity, or suspected adenomyosis. It provides effective bleeding reduction and contraception; alternatives should be discussed if declined or unsuitable.

Reference: NICE NG88: Heavy menstrual bleeding: https://www.nice.org.uk/guidance/ng88/chapter/recommendations