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LNG-IUD and HRT — DFSRH MCQ

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HardIntrauterine contraceptionLNG-IUD and HRTDFSRH

A 50-year-old woman has a 52 mg LNG-IUD inserted 6 years ago and now starts transdermal oestrogen for menopausal symptoms. She relies on the device for endometrial protection. What is the most appropriate management?

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Correct answer: D — Replace the 52 mg LNG-IUD for HRT endometrial protection

Extended contraceptive use does not mean extended endometrial protection with systemic oestrogen. A 52 mg LNG-IUD used for HRT protection needs replacement at the appropriate interval. The trap is conflating contraceptive duration with HRT indication.

Reference: FSRH Intrauterine Contraception Guideline 2023; UKMEC 2025; BNF