Using Clinical Judgment in Special Cases

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.

• Breastfeeding and less than 4 weeks since giving birth (considering the risks of another pregnancy and that a woman may have limited further access to the LNG-IUD)
• Acute blood clot in deep veins of legs or lungs
• Had breast cancer more than 5 years ago, and it has not returned
• Severe liver disease, infection, or tumor
• Systemic lupus erythematosus with positive (or unknown) antiphospholipid antibodies

See also Copper-Bearing IUD, Using Clinical Judgment in Special Cases.