Which contraception method has the fewest systemic estrogen-related contraindications?

• A. LNG IUS
• B. Copper IUD
• C. Condoms
• D. Combined oral contraceptive pill

Answer: (B)

Estrogen-related contraindications apply to products that use estrogen; the fewer or none of those hormones a method contains, the fewer estrogen-specific risks it carries.

The copper IUD is non-hormonal, delivering no estrogen at all. That means there are no systemic estrogen exposures to worry about, so it has no estrogen-related contraindications. In contrast, methods that include estrogen (like the combined oral contraceptive pill) carry the full range of estrogen-related contraindications (VTE risk, certain migraines, liver disease, etc.). The LNG IUS uses progestin with minimal systemic absorption, so estrogen contraindications aren’t a concern, but it isn’t hormone-free, whereas the copper IUD is entirely hormone-free, making it the option with the fewest systemic estrogen-related constraints.