Intrauterine device and upper-genital-tract infection: a real association?

Abstract

The intrauterine device (IUD) is a reversible contraceptive method, eligible for different types of patients and clinical conditions, according to the World Health Organization (WHO). Pelvic inflammatory disease (PID), a gynecological infection that affects the upper genital tract, transmitted by sex, may be related to the method in some specific situations. This review article is intended to assess the occurrence of PID linked to IUD insertion and use. A literature review was carried out, with a search in the Scielo, Pubmed and Google Academic databases, and after applying the inclusion and exclusion criteria, twelve national and international scientific articles were selected, without restriction by period. The data collected demonstrate that the association between the introduction of the IUD and PID is not frequent, and are related to some specific factors, which can independently increase the risk of developing the infection. Regarding the time of use, there may be an association with a rare bacterial infection (actinomycosis), which requires specific investigation for elucidation. Some clinical and serological tests can be used prior to insertion of the IUD, but they should not limit its use and application. Therefore, the use of the IUD should not be discouraged due to the risk of infection, as it is a safe and effective family planning strategy.