IUD With Copper - Contraindications

Contraindications

A category 3 condition indicates conditions where the theoretical or proven risks usually outweigh the advantages of inserting a copper IUD. A category 4 condition indicates conditions that represent an unacceptable health risk if a copper IUD is inserted.

Women should not use a copper IUD if they:

(Category 4)

• Are pregnant or think they may be pregnant
• Septic pregnancy or abortion
• Have unexplained abnormal vaginal bleeding
• Have untreated cervical cancer
• Have malignant gestational trophoblastic disease
• Have uterine cancer
• Have certain uterine abnormalities
• Have or may have had a pelvic infection within the past three months
• Have or may have an STI
• Have pelvic tuberculosis

(Category 3)

• Are postpartum between 48 hours and 4 weeks (increased IUD expulsion rate with delayed postpartum insertion). The CDC and WHO criteria differ in their recommendation for women postpartum between 48 hours and 4 weeks. The CDC does not list this as a contraindication.
• Have benign gestational trophoblastic disease
• Have ovarian cancer
• Have AIDS (unless clinically well on anti-retroviral therapy)
• Have very high individual likelihood of exposure to gonorrhea or chlamydial STIs

A full list of contraindications can be found in the WHO Medical Eligibility Criteria for Contraceptive Use and the CDC United States Medical Eligibility Criteria for Contraceptive Use.

While nulliparous women (women who have never given birth) are somewhat more likely to have side effects, this is not a contraindication for IUD use. Overall, IUDs are safe and acceptable also in young nulliparous women. The same is likely the case for virgin women, unless there is a microperforate hymen that obstructs any insertion of the IUD.