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IUD and cervical screening — DFSRH MCQ

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HardIntrauterine contraceptionIUD and cervical screeningDFSRH

A 29-year-old booked for an LNG-IUD is overdue cervical screening, has no abnormal bleeding or cervical symptoms and declines screening today. What is appropriate?

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Correct answer: A — Proceed with insertion and discuss screening separately

The best answer is “Proceed with insertion and discuss screening separately”. Being overdue cervical screening is not itself a contraindication to IUD insertion. Screening should be explained and encouraged but requires consent and should not become a coercive barrier to contraception. Abnormal bleeding, a suspicious cervix or an existing abnormal result would instead require the relevant diagnostic pathway.

Reference: CoSRH/FSRH, Intrauterine contraception (amended January 2025): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-clinical-guideline-intrauterine-contraception-mar-23-amended.pdf