A 38-year-old woman presents to the GP with intermenstrual bleeding. She has a levonorgestrel intrauterine system in situ (inserted 4 years ago for co...

Question

A 38-year-old woman presents to the GP with intermenstrual bleeding. She has a levonorgestrel intrauterine system in situ (inserted 4 years ago for contraception). She has no pain. Speculum examination shows a normal cervix with IUD threads visible. Her cervical screening is up to date and was HPV negative. Which is the single most appropriate action?

Accepted Answer

Arrange a pelvic ultrasound and check the position of the LNG-IUS

Answer

Reassure that IMB is normal with the LNG-IUS even after 4 years

Answer

Remove the LNG-IUS and replace with a new one

Answer

Prescribe a short course of norethisterone

Answer

Refer urgently for colposcopy

uk-drcog MCQ (SBA): New IMB with LNG-IUS