A 38-year-old woman with three children requests contraception. She also suffers from heavy regular menstrual bleeding causing anaemia, for which she wishes to avoid hysterectomy. Which contraceptive would address BOTH her needs?

• A Levonorgestrel-releasing intrauterine system ✓
• B Copper-T 380A intrauterine device
• C Combined oral contraceptive pills
• D Depot medroxyprogesterone acetate injection

Explanation

The levonorgestrel-releasing intrauterine system releases levonorgestrel locally, producing decidual atrophy and suppression of the endometrium, and reduces menstrual blood loss by around 70 to 90 percent. It is an established treatment for menorrhagia while providing contraception with a Pearl Index near 0.1 to 0.2. The copper device tends to increase menstrual blood loss, so it worsens her anaemia. DMPA may reduce bleeding but causes irregular bleeding and bone density concerns with long use.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.