A 35-year-old woman with hypertension and a BMI of 32 kg/m² requests reliable contraception. She is a non-smoker. She has completed her family. She has no personal or family history of VTE. The MOST appropriate long-acting reversible contraceptive (LARC) is:

• A Combined oral contraceptive pill
• B Levonorgestrel intrauterine system (LNG-IUS 52 mg) ✓
• C Combined contraceptive patch
• D Copper intrauterine device

Explanation

Combined estrogen-progestogen methods (OCP, patch) are UKMEC Category 3 or 4 in women with hypertension (BP ≥ 140/90), primarily due to VTE and arterial thrombosis risk; combined methods are contraindicated with uncontrolled hypertension. LNG-IUS contains only levonorgestrel with minimal systemic absorption, is UKMEC 1–2 for hypertension, highly effective (>99%), reduces menstrual loss, and is a superior LARC choice. Copper IUD is also LARC and acceptable but can worsen menorrhagia; LNG-IUS is preferred given the metabolic profile.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.