Medical Eligibility Criteria for
Copper-Bearing IUDs

Ask the client the questions below about known medical conditions. If she answers "no" to all of the questions, then she can have an IUD inserted if she wants. If she answers "yes" to a question, follow the instructions. In some cases she can still have an IUD inserted. These questions also apply to the levonorgestrel IUD.

1.    Did you give birth more than 48 hours ago but less than 4 weeks ago?

NO    YES Delay inserting an IUD until 4 or more weeks after childbirth (see Soon after childbirth).

2.    Do you have an infection following childbirth or abortion?

NO    YES If she currently has infection of the reproductive organs during the first 6 weeks after childbirth (puerperal sepsis) or she just had an abortion-related infection in the uterus (septic abortion), do not insert the IUD. Treat or refer if she is not already receiving care. Help her choose another method or offer a backup method.^* After treatment, re-evaluate for IUD use.

3.    Do you have vaginal bleeding that is unusual for you?

NO    YES If she has unexplained vaginal bleeding that suggests pregnancy or an underlying medical condition, use of an IUD could make diagnosis and monitoring of any treatment more difficult. Help her choose a method to use while being evaluated and treated (but not a hormonal IUD, progestin-only injectables, or implants). After treatment, re-evaluate for IUD use.

4.    Do you have any female conditions or problems (gynecologic or obstetric conditions or problems), such as genital cancer or pelvic tuberculosis? If so, what problems?

NO    YES Known current cervical, endometrial, or ovarian cancer; gestational trophoblast disease; pelvic tuberculosis: Do not insert an IUD. Treat or refer for care if she is not already receiving care. Help her choose another method. In case of pelvic tuberculosis, re-evaluate for IUD use after treatment.

5.    Do you have AIDS?

NO    YES Do not insert an IUD if she has AIDS unless she is clinically well on antiretroviral therapy. If she is infected with HIV but does not have AIDS, she can use an IUD. If a woman who has an IUD in place develops AIDS, she can keep the IUD (see IUDs for Women With HIV).

6.    Assess whether she is at very high individual risk for gonorrhea or chlamydia.

NO    YES Women who have a very high individual likelihood of exposure to gonorrhea or chlamydia should not have an IUD inserted (see Assessing Women for Risk of Sexually Transmitted Infections).

7.    Assess whether the client might be pregnant.

NO    YES Ask the client the questions in the pregnancy checklist. If she answers "yes" to any question, she can have an IUD inserted (see also When to Start).

^* Backup methods include abstinence, male and female condoms, spermicides, and withdrawal. Tell her that spermicides and withdrawal are the least effective contraceptive methods. If possible, give her condoms.

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.