A woman had a Cu-IUD inserted 2 years ago. She now presents with a single episode of prolonged menstrual bleeding lasting 14 days. This is unusual for...

Question

A woman had a Cu-IUD inserted 2 years ago. She now presents with a single episode of prolonged menstrual bleeding lasting 14 days. This is unusual for her. Pregnancy test is negative. What is the most appropriate investigation?

Accepted Answer

Perform STI screening and consider pelvic ultrasound to exclude pathology

Answer

No investigation needed; Cu-IUD always causes heavy bleeding

Answer

Remove the Cu-IUD immediately

Answer

Prescribe tranexamic acid without further investigation

Answer

Switch to an LNG-IUS without investigating

uk-dfsrh MCQ (SBA): Change in Bleeding Pattern with Cu-IUD Investigation

A woman had a Cu-IUD inserted 2 years ago. She now presents with a single episode of prolonged menstrual bleeding lasting 14 days. This is unusual for her. Pregnancy test is negative. What is the most appropriate investigation?