How many days after treating Chlamydia could I insert an IUD if she has no florid cervicitis or an active pelvic infection? #701/14

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.

 

Jenny Stringer


A:       

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.

 

Long answer:

A Kaiser Permanente study in Northern California of 57,728 IUD insertions found a 0.54% (1 in 2,000) rate of infection in the 90 days post IUD insertion.  There was not a difference in the risk of infection:

  • 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

 

Reference:

Suffrin CB. et al Obstet Gynec, 2012

 

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October 28, 2014