Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the advised treatment option for dysmenorrhea and menorrhagia in sexually active women?

1. Depo-Provera

2. Mirena or Jass

3. Combination oral contraceptives

4. Estradiol patches

The correct answer is: Mirena or Jass

The advised treatment option of Mirena or Jass for dysmenorrhea and menorrhagia in sexually active women is beneficial primarily due to their mechanism of action as hormonal intrauterine devices (IUDs). Mirena releases levonorgestrel, a progestin that not only helps in regulating the menstrual cycle but also significantly reduces menstrual blood loss. This makes it particularly effective for women suffering from both heavy menstrual bleeding (menorrhagia) and painful periods (dysmenorrhea). The local action of the contraceptive on the endometrial lining minimizes the lining's thickness, which can relieve pain and reduce the amount of bleeding experienced during menstruation. The use of hormonal IUDs also has the added benefit of offering long-term contraception, which is convenient for sexually active women. Other treatment options, while they may also address either dysmenorrhea or menorrhagia separately, do not combine the benefits as effectively as Mirena in this specific scenario. For instance, combination oral contraceptives can help manage dysmenorrhea and may reduce bleeding, but they require consistent daily intake and may not provide the same level of localized relief as Mirena. Similarly, methods like Depo-Provera can alleviate