A 45-year-old LNG-IUD user has new intermenstrual bleeding after years of amenorrhoea. She has BMI 36 kg/m2 and a normal pregnancy test. What is the

Question

A 45-year-old LNG-IUD user has new intermenstrual bleeding after years of amenorrhoea. She has BMI 36 kg/m2 and a normal pregnancy test. What is the most appropriate investigation?

Accepted Answer

Assess cervix and refer for endometrial evaluation according to abnormal bleeding pathway

Answer

Treat bacterial vaginosis empirically

Answer

Reassure because LNG-IUD causes bleeding

Answer

Replace LNG-IUD immediately

Answer

Give tranexamic acid without examination

IUD with unexplained bleeding — DFSRH MCQ

A 45-year-old LNG-IUD user has new intermenstrual bleeding after years of amenorrhoea. She has BMI 36 kg/m2 and a normal pregnancy test. What is the most appropriate investigation?