Abstract
Concerns exist as to whether the insertion of copper and levonorgestrel-releasing
intrauterine devices (IUDs) increases the risk of pelvic inflammatory disease (PID)
among women with sexually transmitted infection (STI). We searched the MEDLINE database
for all articles published between January 1966 and March 2005 that included evidence
relevant to IUDs and STIs and PID. None of the studies that examined women with STIs
compared the risk of PID between those with insertion or use of an IUD and those who
had not received an IUD. We reviewed indirect evidence from six prospective studies
that examined women with insertion of a copper IUD and compared risk of PID between
those with STIs at the time of insertion with those with no STIs. These studies suggested
that women with chlamydial infection or gonorrhea at the time of IUD insertion were
at an increased risk of PID relative to women without infection. The absolute risk
of PID was low for both groups (0���5% for those with STIs and 0���2% for those without).
Keywords
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Article info
Publication history
Published online: October 17, 2005
Accepted:
August 11,
2005
Received:
July 27,
2005
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.