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Heavy menstrual bleeding — DRCOG MCQ

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HardGynaecologyHeavy menstrual bleedingDRCOG

A woman has regular heavy periods, no intermenstrual bleeding and a normal pelvic examination. What is the most appropriate first-line treatment?

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

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Correct answer: A — Offer a levonorgestrel intrauterine system if suitable

For heavy menstrual bleeding with no identified pathology or small fibroids not distorting the cavity, NICE recommends an LNG-IUS as first treatment when acceptable. Discuss alternatives if it is unsuitable or declined.

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