Question

Use of Levo-Norgestrel Releasing intrauterine contraceptive device is helpful in all of the following conditions except:

• A. Menorrhagia
• B. Dysmenorrhea
• C. Premenstrual symptoms
• D. Pelvic inflammatory disease

Hint:

LNG-IUS helps heavy/painful periods and PMS but active PID is a contraindication to insertion, not an indication.

Answer 1

The Correct Option is D

Step 1: Understanding the Question:
The Levonorgestrel releasing intrauterine system (LNG-IUS, brand name Mirena) releases a steady low dose of progestin directly into the uterine cavity. We need the condition among the four that this device does NOT help.

Step 2: Key Formula or Approach:
The local progestin thins the endometrium and thickens cervical mucus. This gives strong benefit for menorrhagia, dysmenorrhea, and premenstrual symptoms, but active pelvic infection is a contraindication for any IUD, not a condition it treats.

Step 3: Detailed Explanation:
Menorrhagia: a thin, atrophic endometrium bleeds far less, so the LNG-IUS is now first line medical treatment for heavy menstrual bleeding.
Dysmenorrhea: less endometrial tissue and lower local prostaglandin production ease period pain, so it helps here too.
Premenstrual symptoms: by suppressing the cyclical build up and shedding of the endometrium, it can ease some premenstrual complaints in many users.
Pelvic inflammatory disease: any intrauterine device, including the LNG-IUS, must not be placed in a woman with active PID or unresolved pelvic infection, because insertion can push organisms upward and worsen infection. So it is not a treatment for PID, it is in fact contraindicated when infection is active.

Step 4: Final Answer:
The LNG-IUS helps menorrhagia, dysmenorrhea and premenstrual symptoms, but is not useful for, and is contraindicated in, active pelvic inflammatory disease.
\[ \boxed{\text{Pelvic inflammatory disease}} \]