A 30-years-old woman para 2+0, hypertension have menorrhagia. Which is best treatment for her?
In this particular question, female is 30 years old i.e. very young so we should not choose hysterectomy or endometrial ablation as the management of choice because in future she might desire pregnancy.
Patient is hypertensive, hence OCPs are contraindicated, so our answer by exclusion is Mirena which is logically also correct, as this patient has 2 children so she may not desire pregnancy presently.
Thus, Mirena serves 2 purposes in this female
I. Controls bleeding
II. Contraceptive benefit.
In future, if she desires pregnancy, she may get mirena removed.
Combined pills
Mirena
Hysterectomy
Transcervical resection of endometrium