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UKMEC unexplained vaginal bleeding — DFSRH MCQ

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HardUKMECUKMEC unexplained vaginal bleedingDFSRH

A 44-year-old requests a 52 mg LNG-IUD for contraception and heavy bleeding. She reports new postcoital bleeding for 2 months and has a friable cervix on speculum examination. Pregnancy test is negative. What is the most appropriate management?

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Correct answer: C — Investigate the bleeding before fitting the LNG-IUD

Unexplained or suspicious genital bleeding should be evaluated before initiating an intrauterine hormonal method. The visible friable cervix and postcoital bleeding require assessment rather than attributing symptoms to perimenopause. A contraceptive bridge may be needed, but fitting the LNG-IUD immediately is not the best answer.

Reference: FSRH UKMEC; NICE Suspected Cancer Guidance