The copper IUD:
When to insert an IUD?
An IUD can be inserted at any time of the menstrual cycle when there is good reason to believe that the woman is not pregnant. The use of an IUD during pregnancy increases the risk of spontaneous abortion. It is not necessary to go to a consultation prior to insertion, to the extent possible, counseling, screening and gynecological exam to be held the same day as insertion.
At what age a woman can use an IUD?
There is no restriction as to age, but the incidence of sexually transmitted diseases is higher among young women because of their lifestyle and their sexual behavior. Therefore, it must provide careful counseling to them about the risk of pelvic inflammatory disease (PID) and infertility.
The IUD is it appropriate to nulliparous women?
Yes. However, the IUD should not be the contraceptive method of choice in these women because of increased risk of expulsion. In addition, nulliparous woman is usually young and she can have sexual behavior that promotes the risk of PID, which are that it is not a good candidate for IUD use.
Women who have irregular menstrual cycles should they use an IUD?
If adequate counseling is provided, menstrual irregularities should not affect IUD use. The rules are usually more abundant if the woman is wearing an IUD, and bleeding may occur intermensuels; these phenomena subside over time. Taking iron supplements by mouth may improve hemoglobin levels if the bleeding is heavy or if the woman is anemic. If pain in the first month after insertion, the woman can be treated short term with a non-steroidal anti-inflammatory drug other than aspirin. If the woman wants the IUD or if pelvic infection is diagnosed, it must remove the IUD.
A woman who has a sexually transmitted disease (STD) need to use an IUD? Can she do it later?
A woman with an STD, or who had had one during the last three months, should not use IUDs. Any STD, purulent cervicitis or PID should be treated. If, in future, women will be exposed at low risk of STDs, and enjoys a thorough counseling, it may be an IUD inserted when the infection has been treated and cured. In cases of acute PID, it takes three months after cure before inserting an IUD.
A woman at risk for STDs Should use an IUD?
IUD users, especially young women, should have a low risk of STDs. A woman at low risk for STDs does not need to undergo laboratory examination before starting to use an IUD. However, if other more appropriate methods are not available or not acceptable, even women at high risk for STDs can use an IUD, according to World Health Organization (WHO), provided they are monitored during the first six weeks after insertion in order to detect any infection.
If the cervix is red, can you insert an IUD?
Yes, if the redness is due to ectopy / ectropion of the cervix, which is not an infection, or a cervical erosion (low trauma) if the woman is not at risk for STDs and If the pelvic exam is normal (not cervicitis). The cervical ectropion (eversion of cylindrical epithelial tissue of the cervix) is a normal condition in many women.
A woman with a history of PID, but no current risk of STDs, should it use an IUD?
According to WHO, history of PID do not affect the use of the IUD if pregnancy occurred subsequently. If there were no pregnancy since the MIP, the risk of recurrence increased slightly, but the benefits generally outweigh the risks.
When can I insert an IUD in postpartum?
Immediately after delivery, during or immediately after cesarean (special training is required) before the start of maternity (but within 48 hours after delivery) from the fourth week postpartum in For Copper T IUD and the sixth week for all other types of IUDs. Special training is required for inserts made before the start of motherhood because of the increased risk of uterine perforation or expulsion.
The IUD can be inserted immediately after abortion?
Yes, in case of spontaneous or induced abortion, except where: infection or risk of infection of the uterus, severe trauma to the genital tract, bleeding or severe anemia. All of these must be cured prior to insertion. The IUD insertion following abortion performed after 16 weeks (second quarter) could be accompanied by an increased risk of expulsion and it must be done only by specially trained staff, because the uterine cavity is too extended to the usual techniques of insertion.