What should a clinician assess before considering levonorgestrel-releasing intrauterine system (LNG-IUS) use?
• After counselling, the LNG-IUS is a suitable option for most women who need contraception and/or treatment for menorrhagia (Grade C). After counselling about other contraceptive methods, women who are assessed as at a higher risk of sexually transmitted infection (STI) may still choose to use the LNG-IUS (Good Practice Point). After considering other contraceptive methods, a woman may use the LNG-IUS within 3 months of treated pelvic infection, provided she has no signs or symptoms (Good Practice Point). Women with a history of migraine with focal symptoms may use the LNG-IUS. If, however, migraine with focal symptoms develops in a LNG-IUS user, these new symptoms should be investigated and other contraceptive options discussed (Good Practice Point). Non-hormonal contraception is most appropriate for a woman with a history of breast cancer. However, the LNG-IUS may be considered individually, and in consultation with the woman’s breast surgeon (Good Practice Point). • Levels of LNG i
