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Contraceptive Pearl: Pelvic Inflammatory Disease and the IUD

According to the World Health Organization, about 160 million women worldwide use the IUD, making it one of the most popular methods of contraception. Is the IUD a safe contraceptive method for women who have had pelvic inflammatory disease?

Good news!  Recent research has found that women who have had PID in the past (both with and without subsequent pregnancies) can safely use the IUD. However, women diagnosed with current PID should not have an IUD inserted until the infection has resolved. Research has suggested that women with STIs at the time of IUD insertion have higher rates of PID as compared to women who do not receive an IUD (with rates of diagnosed PID ranging from 0% to 5% in women with STIs at the time of IUD insertion). However, many of these studies are of low quality and are therefore inconclusive.

Although IUD insertion isn’t advisable for patients with current purulent cervicitis, chlamydia, or gonorrhea, women who contract one of these infections with an IUD in place can be treated safely without removing the IUD.

The IUD provides safe, long-term and highly effective contraception for women of all ages. To help your patients choose an IUD, see our IUD Information patient education fact sheet.

We appreciate your feedback! Please write us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.

 

Helpful Resources

Medical Eligibility for Initiating Contraception

Patient Assistance Program for Progestin IUD

Patient Assistance Program for Copper IUD

IUD Fact Sheet

Copper IUD User Guide

Progestin IUD User Guide

 

Sources

Mohallajee, AP, Curis KM, Peterson HB.  Does insertion of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? a systematic review.  Contraception, 2006; 73: 145-153. DOI:  10.1016.

UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. A plethora of IUDS: but how safe, how effective?  Prog Reprod Health Res 2002; 60:3.

 

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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