An intrauterine device, or IUD, is a long-term form of contraception. The small, T-shaped device is placed into the uterus by a health-care provider to prevent pregnancy. An IUD is a highly effective method of birth control that can remain in place for 3 to 10 years and is reversible upon removal. While uncommon, infections can occur with an IUD, usually shortly after placement. Signs and symptoms associated with infections should be assessed immediately by a health-care provider.
Pelvic Inflammatory Disease
Pelvic inflammatory disease, or PID, is an infection of the pelvic organs, typically involving the uterus and ovarian tubes. According to the authors of a March 2009 article in "Acta Obstetricia et Gynecologica Scandinavica," the risk of PID is highest in the first month after insertion of an IUD. PID occurs most frequently in women at high risk for a sexually transmitted infection or currently infected with an STI. Symptoms can be mild or severe, including pain in the lower abdomen, fever, pain during sex, painful urination, foul smelling discharge and irregular vaginal bleeding. PID can progress quickly, so immediate medical attention is necessary if symptoms develop.
Infection Following Insertion of an IUD
Infections related to IUDs most often occur because the instrument used for insertion or the IUD itself carries germs from the lower genital tract into the uterus during insertion. Use of infection prevention techniques lowers the risk of infection associated with IUD insertion. If no sexually transmitted infection is present at the time of IUD insertion, there is a 0 to 2 percent risk of PID, according to the authors of a February 2006 article in the journal "Contraception."
Sexually Transmitted Diseases
The risk of infection following insertion of an IUD increases to 0 to 5 percent if a sexually transmitted infection such as chlamydia or gonorrhea is present, note the authors of the 2006 "Contraception" study. For women at high risk for an STI, the doctor may opt to delay insertion or perform a screening test to determine whether treatment is appropriate. An IUD does not protect against STIs. If one is acquired after insertion, it should be treated immediately to avoid spread to the reproductive organs and abdomen. Removal of the IUD is typically not necessary. Symptoms of an STI may include genital itchiness, pain or burning with urination, an abnormal vaginal discharge, irregular vaginal bleeding and discomfort during intercourse.
In rare cases, an infection related to IUD insertion or an STI acquired after placement spreads from the reproductive organs into the abdomen and possibly the bloodstream. Women with this type of severe infection typically experience widespread abdominal pain and tenderness and a high fever. Other signs and symptoms may include nausea, vomiting, low blood pressure, rapid heart rate and dizziness or fainting. Immediate medical attention is needed if any of these symptoms develop.
When to Seek Medical Attention
Pelvic infections or sexually transmitted infections are serious conditions that should be treated right away. Signs and symptoms can be mild, even with a severe infection. Women may mistake infection symptoms for another condition, such as a urinary tract or yeast infection. Seek medical attention right away for any symptoms associated with PID or a sexually transmitted infection.
- New England Journal of Medicine: Long-Acting Methods of Contraception
- Acta Obstetricia et Gynecologica Scandinavica: Infection Risk and Intrauterine Devices
- Contraception: Does Insertion and Use of an Intrauterine Device Increase the Risk of Pelvic Inflammatory Disease Among Women With Sexually Transmitted Infection? A Systematic Review
- American College of Obstetricians and Gynecologists: Long-acting Reversible Contraception -- Implants and Intrauterine Devices
- Pharmacotherapy: Long-Acting Reversible Contraception -- A Review in Special Populations
- Infectious Diseases in Critical Care Medicine; Burke A. Cunha (ed.)