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Eligibility:
- Not usually recommended for young women at increased
risk for STIs
- Not recommended for those with recent or current
STIs
- Under age 20 and nulliparous women may have increase
risk of expulsion
Counseling messages:
- IUDs are not appropriate for those with high-risk
behavior
- Important to check for signs of expulsion
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According to the World Health Organization, IUDs are not recommended
for young women at increased risk of STIs/HIV unless other methods
are unavailable or unacceptable. IUDs should never be inserted
in a woman who has a current infection or has had an STI in
the last three months. IUD use may increase the risk of pelvic
inflammatory disease and infertility among women who have an
untreated STI at the time of insertion or if the procedure is
not performed under sterile conditions. Women under age 20 can
generally use IUDs, although concern exists about an increased
risk of expulsions among those in this age group who have never
borne children.
With careful screening and counseling, IUDs may be used safely
by young women in stable, mutually monogamous relationships.
It is very important to emphasize that IUDs should not be used
by young women at high risk of STIs, including those with multiple
partners or whose partners have multiple partners. It is also
important to counsel young women to look for signs of expulsion
of the IUD by feeling for the IUD string in the cervical opening.
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