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Copper IUD heavy bleeding — DFSRH MCQ

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ModerateIntrauterine methodsCopper IUD heavy bleedingDFSRH

A 37-year-old has used a copper IUD for 8 months and reports heavier, more painful periods. Pregnancy test is negative, pelvic examination is normal and she has no STI risk. She wants ongoing highly effective contraception. What is the most appropriate management?

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Correct answer: A — Discuss switching to a 52 mg LNG-IUD

Copper IUDs can increase menstrual bleeding and dysmenorrhoea; an LNG-IUD can improve bleeding while providing effective contraception. PID treatment is not indicated without infection features. Simply removing contraception risks unintended pregnancy unless an alternative is arranged.

Reference: FSRH Guideline Intrauterine Contraception; NICE Heavy Menstrual Bleeding Guidance