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Intrauterine Device (IUD) for Birth Control
The IUD is most likely to work well for women who have been pregnant before. Women who have never been pregnant are more likely to expel the IUD or have more pain and cramping after insertion. But they can still use the IUD.1
Pelvic inflammatory disease (PID) concerns have been linked to the IUD for years. But it is now known that the IUD itself does not cause PID. Instead, if you have a genital infection when an IUD is inserted, the infection can be carried into your uterus and fallopian tubes. If you are at risk for a sexually transmitted disease (STD), your doctor will test you and treat you if necessary, before you get an IUD.
Intrauterine devices reduce the risk of all pregnancies, including ectopic (tubal) pregnancy. But if a pregnancy does occur while an IUD is in place, it is a little more likely that the pregnancy will be ectopic. Ectopic pregnancies require medicine or surgery to remove the pregnancy. Sometimes the fallopian tube on that side must be removed as well.
IUD use and medical conditions
An IUD can be a safe birth control choice for women who:5
- Have a history of ectopic pregnancy. Both the copper IUD and LNg IUD are appropriate.
- Have a history of irregular menstrual bleeding and pain. The LNg IUD may be appropriate for these women and for women who have a bleeding disorder or those who take blood thinners (anticoagulants).
- Have a risk for bacterial endocarditis. Antibiotics would be used at the time of insertion and removal to prevent infection.
- Have diabetes.
- Are breast-feeding.
- Have a history of endometriosis. The LNg IUD is a good choice for women who have endometriosis.
Considerations
IUDs may not be a good choice if you:
- Have never been pregnant (you are more likely to have pain with an IUD and are more likely to have the IUD come out after it is inserted).
- Have a sexually transmitted disease (STD) currently or had one within the past 3 months.
- Are not willing to use condoms to protect yourself from sexually transmitted diseases.
- Have an active infection of your vagina or cervix.
- Have pelvic inflammatory disease (PID) or have a recent history of PID.
- Have a bleeding disorder or take blood-thinners (anticoagulants). Although you cannot use the copper IUD, you can use the LNg IUD.
- Have a history of problems with IUDs.
- Have abnormalities of your uterus.
- Have a uterine infection after childbirth or a septic abortion.
- Have uterine bleeding of unknown origin.
- Have an allergy to copper, so the copper IUD would not be an option.
If you have one of the older, all-plastic IUDs, such as the Lippes Loop, ask your doctor at your next checkup about replacing this IUD with a more effective copper or hormonal one.
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| Author: | Bets Davis, MFA | Last Updated: May 22, 2008 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology | |
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