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IUD insertion with untreated gonorrhoea — DFSRH MCQ

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HardIntrauterine methodsIUD insertion with untreated gonorrhoeaDFSRH

A 26-year-old woman is due for IUD insertion but has a positive gonorrhoea NAAT from screening taken last week. She has no pelvic pain and is not pregnant. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Treat gonorrhoea and defer routine IUD insertion until infection is appropriately managed

Current untreated gonorrhoea increases risk around intrauterine insertion, so treatment and appropriate timing of insertion are required, with interim contraception. Proceeding before management risks ascending infection. LNG-IUDs do not prevent PID in this setting, and a 12-month delay is unnecessary. The pearl is to screen and manage infection risk without creating a long contraceptive gap.

Reference: FSRH Guideline: Intrauterine Contraception; BASHH Guideline: Gonorrhoea 2025