A 32-year-old woman with a copper IUD in situ for 3 years presents to the GP with a 3-week history of heavier and more painful periods. She has no int...

Question

A 32-year-old woman with a copper IUD in situ for 3 years presents to the GP with a 3-week history of heavier and more painful periods. She has no intermenstrual or postcoital bleeding. Pelvic examination reveals IUD threads in situ and a normal-sized uterus. Which is the single most appropriate first-line management?

Accepted Answer

Prescribe tranexamic acid and mefenamic acid during menstruation

Answer

Remove the Cu-IUD and replace with an LNG-IUS

Answer

Arrange a pelvic ultrasound urgently

Answer

Remove the Cu-IUD and offer no alternative

Answer

Prescribe the combined oral contraceptive pill alongside the Cu-IUD

uk-drcog MCQ (SBA): Heavy Periods with Copper IUD