A 35-year-old woman presents to the GP with chronic pelvic pain and heavy menstrual bleeding. She has a bulky, tender uterus on pelvic examination. Tr...

Question

A 35-year-old woman presents to the GP with chronic pelvic pain and heavy menstrual bleeding. She has a bulky, tender uterus on pelvic examination. Transvaginal ultrasound shows a diffusely enlarged uterus with myometrial cysts and an indistinct endometrial-myometrial junction. She wishes to retain her fertility. Which is the single most appropriate first-line medical treatment?

Accepted Answer

Levonorgestrel intrauterine system (Mirena)

Answer

Tranexamic acid

Answer

Norethisterone 5 mg three times daily continuously

Answer

GnRH agonist for 6 months

Answer

Non-steroidal anti-inflammatory drugs only

uk-drcog MCQ (SBA): Adenomyosis Treatment