This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
A 30 yr old multipara, hypeensive woman complaints of menorrhagia. Which is best treatment for her? 
Select and explain. 
A. Combined pills, B. MIRENA, C. Hysterectomy, D. Transcervical resection of endometrium
B: MIRENA
Answer: B: MIRENA 
Explanation: MIRENA is a levonorgestrel containing IUD paicularly in elderly parous women assuming that they have no history of PID, ectopic pregnancy, leukemia, sickle cell disease or valvular hea disease. In this patient MIRENA is the best treatment for her. It is an effective alternative to hysterectomy to reduce heavy vaginal bleeding. IUD is not indicated for young nulliparous women due to the potential for dysmenorrhea and high risk of STD. Combined OCP is a well accepted and safe method of contraception for teens.