A woman with a Cu-IUD develops heavy menstrual bleeding that persists despite 6 months of tranexamic acid and mefenamic acid. Her Hb is 100 g/L. She w...

Question

A woman with a Cu-IUD develops heavy menstrual bleeding that persists despite 6 months of tranexamic acid and mefenamic acid. Her Hb is 100 g/L. She wishes to continue using IUC. What is the best management?

Accepted Answer

Switch from the Cu-IUD to a 52 mg LNG-IUS, which will provide both contraception and treatment of heavy menstrual bleeding

Answer

Continue the Cu-IUD indefinitely

Answer

Add oral progesterone to the Cu-IUD

Answer

Remove the Cu-IUD and offer no alternative

Answer

Refer for endometrial ablation as the first step

uk-dfsrh MCQ (SBA): Cu-IUD HMB Refractory Switch to LNG-IUS

A woman with a Cu-IUD develops heavy menstrual bleeding that persists despite 6 months of tranexamic acid and mefenamic acid. Her Hb is 100 g/L. She wishes to continue using IUC. What is the best management?