Who Should Avoid the IUD?

If you have a sexually transmitted disease—or risk getting one from a variety of sexual partners—you definitely should not use an IUD. In addition, if you're monogamous but aren't sure about your partner, an IUD might not be the best choice.

IUD manufacturers suggest that a good IUD candidate is a woman who already has had her children. Their concern arises, perhaps, from the potential for lawsuits over infertility, rather than from any medical data.

Known or suspected pregnancy precludes use of an IUD, as does active, recurrent, or recent pelvic infection. Here are some other problems you should discuss with your doctor before deciding whether an IUD is the right choice for you:

• Unexplained, irregular, or abnormal uterine bleeding

• Severe menstrual cramps or heavy periods

• Known or suspected cervical or uterine cancer, including a Pap smear whose results are inconclusive

• A history of endocarditis (heart inflammation), rheumatic heart disease, or the presence of artificial heart valves

• Problems with blood-clotting

• Reduced immune response (sometimes brought on by steroid treatment)

• Previous pregnancies while using an IUD

• A history of IUD expulsion from the uterus

• Abnormal uterine anatomy, such as a wall (septum) down the middle of the uterus, noncancerous tumors underneath the muscle surface which may increase bleeding, or a very thin cervical opening

• A copper allergy or Wilson's disease (excess copper in the body)

• Anemia

• A history of fainting