Candidates for IUD Use

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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)

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