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LNG-IUD for HRT endometrial protection — DFSRH MCQ

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HardIntrauterine methodsLNG-IUD for HRT endometrial protectionDFSRH

A 52-year-old uses a 52 mg LNG-IUD inserted 6 years ago and now wants to start transdermal oestradiol for vasomotor symptoms. She is amenorrhoeic and the IUD was originally fitted for contraception. What is the most appropriate management?

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Correct answer: B — Replace the LNG-IUD before using it for HRT protection

The contraceptive duration of a 52 mg LNG-IUD is not the same as its licensed duration for endometrial protection as part of HRT, which remains shorter. A 6-year-old device should be replaced or another adequate progestogen provided before systemic oestrogen. FSH does not assess endometrial protection.

Reference: FSRH Guideline Contraception for Women Aged Over 40 Years; BNF