A 26-year-old woman with a history of deep vein thrombosis requests contraception. She is a non-smoker. Which of the following methods is MOST appropriate?

• A Combined oral contraceptive pill (COCP)
• B Ethinylestradiol-containing vaginal ring
• C Levonorgestrel-releasing intrauterine system (LNG-IUS) ✓
• D Combined contraceptive patch

Explanation

A personal history of deep vein thrombosis is an absolute contraindication (WHO MEC Category 4) to all oestrogen-containing contraceptives (COCP, vaginal ring, patch) due to the prothrombotic effect of oestrogen. The levonorgestrel-releasing IUS (Mirena) is a progestogen-only method with predominantly local action, no oestrogen component, and minimal systemic absorption, making it safe in women with VTE history. It is WHO MEC Category 2 for history of VTE.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.