Guidelines for insertion of intrauterine devices
Jerve, F.
Tidsskrift for den Norske Laegeforening Tidsskrift for Praktisk Medicin Ny Raekke 110(27): 3505
1990
ISSN/ISBN: 0029-2001 PMID: 2256083 Document Number: 351165
The copper-containing IUD has lost some popularity during the past few years but is still used by over 60 million women around the world. This article presents a short review of the major considerations in prescribing an IUD and in the procedure of inserting it. Suspicion of pregnancy, chronic infection or malignity in the genitalia, and multiple sexual partners are the main contraindications. Previous expulsion or pregnancy with an IUD are strong contraindications, since there may be a tendency for these episodes to repeat. Dysmenorrhea and menorrhagia may become more frequent with an IUD. A general practitioner may insert an IUD, but unless he or she performs the procedure often enough to stay familiar, it is better to refer the patient to a more experienced colleague. Before the IUD is inserted, the patient should receive a usual gynecological examination. The condition of the cervix should be checked and a bacteriological culture made if there is evidence of infection, especially of chlamydia. The position of the uterus should be determined and if it is prolapsed or otherwise out of position, a sounding should be taken as a guide for proper insertion into the fundus. The actual insertion should be done slowly and gently with the patient informed of the progress. The IUD may be inserted at any time in the menstrual cycle but if there is any change of impregnation, it is better to wait until early in the next cycle.