Sexually Transmitted Infections, Pelvic Inflammatory Disease, and the Role from Intrauterine Devices: Myth or Fact?

Abstract

Connections among Intra Uterine Devices (IUD), Sexually Transmitted Diseases (STDs) and Pelvic inflammatory disease (PID) still bring doubts for health professionals; Our goal is to understand better these associations. We searched the PubMed database for articles including evidence about these topics. A common outcome found is the superiority of levonorgestrel (LNG) IUD over NOVA T (copper) device regarding clinical performance and PID rates. The modern IUDs do not elevate the risk of getting PID; however this risk is higher when a patient has a STI at the time she gets an IUD. It is wise requiring a STI test, principally for cervicitis, before placing an IUD. The epidemiologic data suggests this management mainly for woman with a new sexual partner, or with multiple sexual partners, and under age 25. It is also correct inserting an IUD and test for STI at the same day: if positive results come, antibiotics can be used. Old papers usually show a higher risk for PID in IUD users, an outcome not found in recent researches that have improved methodology and therefore are more reliable. However, the investigation concerning the STI and cervicitis remain as an important point to investigate before decision to IUD use.