A 50-year-old female, gravida 3, para 3, presents to the office requesting removal of an intrauterine device (IUD). She had a levonorgestrel IUD placed six years ago for contraceptive purposes and now that she is menopausal wishes removal. Last menstrual period was two years ago, and she has experienced vasomotor symptoms and vaginal dryness. She was never able to palpate the IUD strings nor were they visible on pelvic examinations. She is currently sexually active with a long-standing monogamous partner and has never been exposed to a sexually transmitted disease. She has a family history of breast cancer in first-degree relatives, and no significant past medical or surgical history. She is not taking medications and has no drug allergies.