American Board of Family Medicine (ABFM) Practice Exam

A history of breast cancer is a well-known contraindication for using a progestin-only IUD. Progestins can stimulate the growth of certain types of breast cancer, especially those that are hormone-sensitive. Therefore, the presence of a history of breast cancer raises significant concerns regarding the potential risks associated with the hormonal effects of progestin, making it crucial to avoid using a progestin-only IUD in these patients.

In contrast, stable hypertension does not usually pose an immediate contraindication for a progestin-only IUD, provided that the condition is well managed. Additionally, having no previous uterine surgery is not a contraindication; many patients can have an IUD inserted regardless of their surgical history as long as there are no other specific complications. Lastly, age over 40 is not a contraindication per se; many women over 40 can safely use a progestin-only IUD as long as there are no other health issues or contraindications that would suggest otherwise.