Name a first-line medical therapy for AUB.

Name a first-line medical therapy for AUB.

• A. Oral iron supplementation
• B. Levonorgestrel intrauterine system
• C. Antibiotics
• D. Oral estrogen therapy

Answer: (B)

When addressing abnormal uterine bleeding, a levonorgestrel-releasing intrauterine system is a top first-line option because it delivers progestin directly to the endometrium, causing a local thinning and stabilization of the endometrial lining and markedly reducing menstrual blood loss. Its effect is often substantial, achieving long-lasting control for several years with minimal daily management, and it also provides contraception, which adds to its appeal as a single, practical solution. This approach tends to have fewer systemic hormonal side effects compared with daily pills and is effective across common AUB causes, including ovulatory dysfunction and fibroids. The other choices don’t target bleeding control in the same way. Oral iron helps treat anemia but doesn’t reduce ongoing bleeding. Antibiotics address infection, not the bleeding disorder. Oral estrogen raises concerns about thromboembolism risk and isn’t a preferred first-line strategy for AUB, since it does not offer sustained, effective endometrial control like the LNG-IUS.

When addressing abnormal uterine bleeding, a levonorgestrel-releasing intrauterine system is a top first-line option because it delivers progestin directly to the endometrium, causing a local thinning and stabilization of the endometrial lining and markedly reducing menstrual blood loss. Its effect is often substantial, achieving long-lasting control for several years with minimal daily management, and it also provides contraception, which adds to its appeal as a single, practical solution. This approach tends to have fewer systemic hormonal side effects compared with daily pills and is effective across common AUB causes, including ovulatory dysfunction and fibroids.

The other choices don’t target bleeding control in the same way. Oral iron helps treat anemia but doesn’t reduce ongoing bleeding. Antibiotics address infection, not the bleeding disorder. Oral estrogen raises concerns about thromboembolism risk and isn’t a preferred first-line strategy for AUB, since it does not offer sustained, effective endometrial control like the LNG-IUS.