I have a patient who was just recently diagnosed with Chlamydia (CT) at her annual checkup and now wants a Mirena IUD. How many days after treating Chlamydia would you safely insert an IUD? I can’t find any literature on how long or if you should wait. Or if I could treat her and insert the IUD on the same day.
She may receive an IUD immediately after treatment (i.e. the same day as she receives treatment.
Below is a question which was posted on our website with much more information:
Does screening for STIs need to be done prior to IUD insertion if a woman has no symptoms of a florid vaginal discharge? #501-14
Q: If I have a documented negative GC/CT (gonorrhea/Chlamydia test) from the initial prenatal visit, should I be repeating screening at the time of a postpartum IUD insertion?
A: Short answer:
An IUD may be inserted at the time of the postpartum visit if the woman does not have a clinically diagnosed pelvic infection or a florid vaginal discharge.
A Kaiser Permanente study in
- If there was no screening for Chlamydia and gonorrhea on the day of insertion or in the year before insertion (47.1% of insertions).
- Women were screened on the day of insertion (9.8% of insertion).
- Screening was done 1-8 weeks before insertion (19.1% of insertions).
- Screening was done 8 weeks to 1 year before insertion (23.7% of insertions).
The risk of pelvic infection is low whether or not a woman is screened for Chlamydia and gonorrhea before, on the day of IUD insertion, or is not screened at all. [CB Suffrin et al Obstet Gynec 2012]
To learn more about the advantages and disadvantages of the Mirena IUD; go to: www.managingcontraception.com and click on Choices 2013 edition. You can also order these wonderful new educational books from our website or by calling 404-875-5001. Do you have your copy yet? It is now available in English and Spanish.
Key Words: diagnosed, Chlamydia, Mirena IUD, treating, insertion, Suffrin CB data, advance screening
Suffrin CB. et al Obstet Gynec, 2012
Contraceptive Technology 20th Edition
Managing Contraception 2014-2015