Intrauterine devices and pelvic inflammatory disease: recent developments.
The potential relationship between use of intrauterine devices and pelvic inflammatory disease is one of the most important issues in contraception today. A number of large, sophisticated studies published since mid-1980 have clarified this association. All have consistently revealed an increased risk of pelvic inflammatory disease among intra-uterine device users, but the most objective of these studies indicate a relative risk compared to women using no method (1.5-2.6) lower than previous estimates. For most intrauterine device wearers, the increased risk of pelvic inflammatory disease persists for only a few months after insertion. The Dalkon Shield appears associated with a higher risk of pelvic inflammatory disease than the Lippes Loop, Saf-T-Coil, or copper devices. Careful selection of candidates for intrauterine devices may further reduce the risk of intrauterine device-associated pelvic inflammatory disease.
Grimes
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Department of Obstetrics and Gynecology, University of Southern California, School of Medicine, Los Angeles 90033.
D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D000292:Pelvic Inflammatory Disease / Q000209:etiology*; D012307:Risk Factors