Usually, a woman with any of the conditions listed below should not use an LNG-IUD. In special circumstances, however, when other, more appropriate methods are not available or acceptable to her, a qualified provider who can carefully assess a specific woman’s condition and situation may decide that she can use an LNG-IUD. The provider needs to consider the severity of her condition and, for most conditions, whether she will have access to follow-up.

• Between 48 hours and 4 weeks since giving birth

• Acute blood clot in deep veins of legs or lungs

• Had breast cancer more than 5 years ago, and it has not returned

• Severe cirrhosis or severe liver tumor

• Noncancerous (benign) gestational trophoblast disease

• Has current ovarian cancer

• Is at very high individual risk for STIs at the time of insertion

• Has severe or advanced HIV clinical disease

• Has systemic lupus erythematosus with positive (or unknown) antiphospholipid antibodies and is not receiving immunosuppressive treatment