No restrictions for a woman who has
- given birth and is 20 years old or older
- begun breastfeeding
- undergone a first trimester abortion
- any of these gynecological conditions: irregular menstrual pattern without heavy bleeding; past PID with a subsequent pregnancy; past ectopic pregnancy; cervical intraepithelial neoplasia; cervical ectropion; history of pelvic surgery
- any of most cardiovascular conditions, including hypertension and uncomplicated valvular heart disease
- any of these metabolic conditions: diabetes; obesity; goiter
- any of these liver problems: biliary tract disease; neoplasia; cirrhosis; viral infection
- breast disease, epilepsy, headaches, or who smokes or uses antibiotics
Advantages generally outweigh risks for a woman who has
- not given birth and is under age 20
- recently given birth (but IUD should not be inserted between 48 hours to four weeks after delivery)
- undergone a second trimester abortion
- these gynecological conditions: severe dysmenorrhea; irregular menstrual patterns with heavy bleeding; past PID without a subsequent pregnancy; vaginitis without purulent cervicitis; uterine fibroids or cervical lacerations not distorting uterine cavity or interfering with insertion; endometriosis
- sickle cell disease, iron deficiency anemia, or complicated valvular heart disease
Not recommended, unless other more appropriate methods are not available or acceptable, for a woman who has
- multiple partners, or whose partner has multiple partners
- benign gestational trophoblastic disease
- HIV infection, or high risk of HIV infection
- heavy irregular vaginal bleeding, if anemia is noted clinically
Should not be used by a woman who has
- a pregnancy
- cervical cancer awaiting treatment, endometrial cancer, or ovarian cancer
- infection after childbirth or abortion
- malignant gestational trophoblastic disease
- had an STD, PID or purulent cervicitis within the previous three months
- unexplained vaginal bleeding
- uterine cavity distortion or is otherwise incompatible with insertion
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