Who Can and Cannot Use Levonorgestrel IUDs

Medical Eligibility Criteria for
Levonorgestrel IUDs

Ask the client the Medical Eligibility Criteria questions for Copper-Bearing IUDs. Also ask the questions below about known medical conditions. If she answers "no" to all of the questions here and for the copper-bearing IUD, then she can have an LNG-IUD inserted if she wants. If she answers "yes" to a question, follow the instructions. In some cases she can still have an LNG-IUD inserted.

1.    Did you give birth less than 4 weeks ago?

NO    YES She can have the LNG-IUD inserted as soon as 4 weeks after childbirth (see When to Start).

2.    Do you now have a blood clot in the deep veins of your legs or lungs?

NO    YES If she reports a current blood clot (not superficial clots), and she is not on anticoagulant therapy, do not provide implants. Help her choose a method without hormones.

3.    Do you have severe cirrhosis of the liver, a liver infection, or liver tumor? (Are her eyes or skin unusually yellow? [signs of jaundice])

NO    YES If she reports serious active liver disease (jaundice, active hepatitis, severe cirrhosis, liver tumor), do not provide the LNG-IUD. Help her choose a method without hormones.

4.    Do you have or have you ever had breast cancer?

NO    YES Do not insert the LNG-IUD. Help her choose a method without hormones.

For complete classifications, see Medical Eligibility Criteria for Contraceptive Use. Be sure to explain the health benefits and risks and the side effects of the method that the client will use. Also, point out any conditions that would make the method inadvisable, when relevant to the client.