How do you determine which patients are appropriate candidates for IUD use?
Review the patient's history, focusing on characteristics that increase her risk for complications
Ask about her history concerning sexually transmitted infections and pelvic inflammatory disease, her menstrual cycle, previous contraceptive failures, and future childbearing plans
Keep in mind the following suggestions for IUD use:
Contraception in multiparous and nulliparous women at low risk for sexually-transmitted infections who desire long-term contraception
Contraception in breast-feeding moms
Contraception in women with a history of or at risk for thromboembolism (i.e., smokers)
Treatment of women with menorrhagia/dysmenorrhea (only with progestin-releasing IUD)
Contraindications to IUD insertion include:
Confirmed or suspected pregnancy
History of PID within the past three months
History of postpartum endometritis or infected abortion within the past three months
Current pelvic infection/STI
Uterine abnormality distorting the uterine cavity
Undiagnosed abnormal vaginal bleeding
Known or suspected malignancy of the cervix or uterus
Less than six to eight weeks postpartum
Wilson's disease or copper allergy (for copper-releasing IUD)