IUD

Question 1

Types of IUD

Answer 1

Copper
Levonorgestrel

Question 2

Who is IUD not suitable in?

Answer 2

Under 25 = increased risk of PID
IBD (high risk of infection)

Question 3

Levonorgestrel releasing

Answer 3

Reduced bleeding/period pain
Lower risk of PID
Prescribe by Brand
- Mirena
- Levosert
- Jaydees

Question 4

Mirena

Answer 4

5 years
Contraception
Menorrhagia
Oestrogen opposition in HRT

Question 5

Jaydees

Answer 5

3 years
Contraception

Question 6

Levosert

Answer 6

3 years
Contraception
Menorrhagia

Question 7

Side effects

Answer 7

Pain on insertion/bleeding
PID (abdominal pain)
Uterine perforation
Infection

Question 8

Uterine perforation

Answer 8

MHRA: reports of uterine perforation with IUD.
Report:
- Severe pelvic pain after insertion
- Change in periods
- Pain during sex
- Pain/increased bleeding for more than 3 weeks
- Unable to feel threads

Question 9

Risk of infection

Answer 9

Related to carriage of existing STI
Main excess risk in first 20 days.
Pre-insertion chlamydia screen for high risk groups.
EHC = Abx prophylaxis
Treat as emergency if sustained pain over next 20 days

Question 10

Infection - at risk groups

Answer 10

Under 25
New partner
Multiple partners in past year
Regular partner has other partners
Local prevalence
History of STI

Question 11

Removal of IUD

Answer 11

Do not remove mid-cycle unless additional contraceptive used for 7 days
If removal essential and UPSI occurs, give EHC
Pregnant = remove in 1st trimester