This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endometriosis and dysmenorrhea, Subject name: Gynaecology & Obstetrics
Treatment of choice of perimenopausal adenomyosis is : 
Select and explain. 
A. OCP, B. LNG IUCD, C. GnRH agonists, D. Hysterectomy
D: Hysterectomy
Answer: D: Hysterectomy 
Explanation: A diagnostic hysteroscopy combined with a curettage is the initial step in the management of adenomyosis because of menorrhagia. Since most women are elderly and past the age of childbearing, total hysterectomy is the treatment. Reference: Shaw's Textbook of Gynaecology 16th edition page no 421