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  • Dr.Niraj Mahajan
  • Dr.Niraj Mahajan
  • Dr.Niraj Mahajan
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    By AdminPosted On 05-Oct-2016

    1. LNG-IUCD or Mirena

    Regarding LNG-IUCD (Mirena), which of the following statement/s are correct

    a) Light periods

    b) Amenorrhoea

    c) Decreased risk of cervical carcinoma

    d) Decreased risk of STD

    e) Decreased risk of ectopic pregnancy

    Correct Answer: 20% of b) Amenorrhoea.
    Poorly framed question. Mirena causes irregular bleeding and spotting in the first 3 to 6 months of use.
    After that time periods become shorter and lighter, and 20% of women stop having periods after 1 year of u
    Light periods is oligo/hypo menorrhoea or scanty menses, which does not occur with Mirena. Amenorroea also in only 20% women after 1 yr use.
    It increases risk of ectopic pregnancy.
    It does not protect STD.
    It does not protect against any malignancy. There is no clear evidence for protection of endometrial ca. as all studies are small scale studies.

    2. Contraceptive in heart disease

    Which one of the following is the ideal contraceptive for a patient with heart disease:

    a) IUCD
    b) Inj. DMPA
    c) Diaphragm
    d) Combined oral contraceptive pills
    e) Progesterone only pills

    Correct answer : Mirena or poor question as risk of heart disease is not specified. AHA ( American Heart Association, European Society of Cardiology (ESC) and WHO Guideline. In patients with uncomplicated valvular heart disease (without coexisting conditions), one may use any form of contraception, including COCs. Progestin-only methods are safe for all heart conditions. However, different methods are more or less effective. They also differ in how they are given. Progestin-only contraceptives often cause irregular bleeding.

    A new option for women with heart disease is the Mirena IUS. The Mirena IUS is a type of IUD that slowly releases progestin over five years. It is extremely effective and often causes menstrual bleeding to stop. Unlike some other IUDs, the risk of heart infection (endocarditis) is low. But it is probably best avoided if patient is at very high risk of heart infection.

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    Dr. Niraj Mahajan

    MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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