From the Research
Diagnosing menopause in women with an IUD in place requires a clinical assessment and may involve the discontinuation of the IUD and observation of amenorrhea, as hormonal assays or imaging are not recommended for diagnosis. According to the most recent guidelines 1, the diagnosis of menopause is typically made retrospectively, based on a 12-month period of consecutive amenorrhea in a compatible age group. However, in women using hormonal contraception, such as an IUD, this diagnosis can be more complex.
The key factors to consider in diagnosing menopause in women with an IUD include:
- The type of IUD (hormonal or copper)
- The presence of menopausal symptoms such as hot flashes, vaginal dryness, and sleep disturbances
- The patient's age and menstrual history
- The potential need for FSH testing, although this is not generally recommended for women with an IUD 1
In general, the proposed strategy for diagnosing menopause in women with an IUD is to discontinue the IUD, remove it, and then follow the patient clinically for the occurrence of amenorrhea. This approach is based on expert opinion and takes into account the potential effects of the IUD on menstrual patterns and hormone levels.
It's also important to note that menopause diagnosis in IUD users is challenging because the device itself can affect the symptoms used to identify this transition. Therefore, a thorough clinical assessment and careful consideration of the patient's individual circumstances are necessary to make an accurate diagnosis.
Overall, diagnosing menopause in women with an IUD requires a thoughtful and individualized approach, taking into account the latest clinical guidelines and the patient's unique needs and circumstances 1, 2.