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Contraception - levonorgestrel intrauterine system (LNG-IUS) assessment

Questionnaire/history: Requested method? Previous method? Since when? Side effects? Menstrual periods: - Duration? - Heaviness? - Timing? - LMP? IMB or PCB? Breast aware/self-examination? Last cervical screening? Result? Pregnancy excluded? Risk of STIs? Risk for sexual abuse, rape and non-consensual sex? Past medical history? - Smoking? - Obesity? - Hypertension? - Diabetes? - Venous thromboembolism? - Headache or migraine? - Menorrhagia, fibroids or previous ectopic pregnancy? - Epilepsy? - STI or pelvic inflammatory disease? Reproductive history? Current medication? - Liver enzyme inducing drugs? Comorbidities and special personal characteristics? Drug allergies? Examination: Blood pressure? Height? Weight? BMI? Management: UK Medical Eligibility Criteria for Contraception (UKMEC) considered? Advised: - Relative efficacy of the method - How the method work - Common adverse effects - Possible drug interactions - Health risks and benefits of the methods - Information on infertility after discontinuing the methods - To read information at www.nhs.uk and www.sexwise.org.uk Resource(s): FSRH: UK Medical Eligibility Criteria for Contraception (UKMEC) NICE CKS: Levonorgestrel intrauterine system Information for patient: NHS Health A to Z: Intrauterine system (IUS) Sexwise: IUS (Intrauterine system)

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