Washington: The risk of developing pelvic inflammatory disease (PID) following insertion of an intrauterine device (IUD) is very low, a new study has found.
The findings correct long-standing misperceptions that IUDs cause PID.
Also, by evaluating the relationship between the timing of testing for gonorrhea and chlamydia (GC/CT) and the risk of developing PID within 90 days after IUD insertion, the study fills a large gap in the evidence base for the optimal timing and necessity of testing women who have no symptoms of gonorrhea and chlamydia.
Because gonorrhea or chlamydia infection is a risk factor for PID in any woman, there is a concern that inserting an IUD in someone who has an asymptomatic infection could increase that risk of PID.
This study shows that protocols that test on the same day as IUD insertion, and then promptly treat women who test positive, do not increase the risk of developing PID compared to women who were screened ahead of time or not at all.
"This study affirms that there is a low risk of pelvic inflammatory disease after IUD insertion, which has the potential to reduce barriers to IUD access, such as making women have a separate screening visit before the IUD insertion," said lead author Carolyn B. Sufrin, MD, MA, of University of California, San Francisco``s Bixby Center for Global Reproductive Health.
The researchers explained that the most accurate time to clinically assess and screen for cervical infection is on the day of IUD insertion. They also emphasized that a woman``s risk status does not depend on her method of contraception, or when she is screened, but rather on sexual behaviors.
Women with high-risk sexual behaviors continue to be at increased risk of GC/CT acquisition even after IUD placement, they said.
"IUDs are among the safest, most effective methods of contraception and provide benefits in managing vaginal bleeding, chronic pelvic pain and a condition called endometriosis, which occurs when cells from the lining of the uterus grow in other areas of the body. Whereas the risk of pregnancy is 9 percent annually with pills, patches and rings, IUDs allow women almost complete control in planning their pregnancies," explained the researchers.
The study has been published in the current online issue of Obstetrics and Gynecology.