Appendix F: Management of Intrauterine Devices When Users Are Found To Have Pelvic Inflammatory Disease

At a glance

This appendix summarizes recommendations for health care providers on management of intrauterine devices when users are found to have pelvic inflammatory disease. This information comes from the 2024 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). The U.S. SPR provides recommendations for health care providers that address a selected group of common, yet sometimes complex, issues regarding initiation and use of specific contraceptive methods.

Figure F1.

Figure F1. Management of intrauterine devices when users of copper intrauterine devices or levonorgestrel intrauterine devices are found to have pelvic inflammatory disease*

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Management of intrauterine devices when users of copper intrauterine devices or levonorgestrel intrauterine devices are found to have pelvic inflammatory disease
Management of intrauterine devices when users are found to have pelvic inflammatory disease
  • Treat PID according to the CDC Sexually Transmitted Infections Treatment Guidelines
  • Counsel about condom use
  • IUD does not need to be removed

Patient wants to continue IUD

  • Reassess in 48–72 hours
  • Clinical improvement
    • Continue IUD
  • No clinical improvement
    • Continue antibiotics
    • Consider removal of IUD
    • Offer another contraceptive method
    • Offer emergency contraception

Patient wants to discontinue IUD

  • Remove IUD after beginning antibiotics
  • Offer another contraceptive method
  • Offer emergency contraception
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Abbreviations: IUD = intrauterine device; PID = pelvic inflammatory disease.

* Refer to CDC Sexually Transmitted Infections Treatment Guidelines for information on PID diagnostic considerations and treatment regimens.

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); Division of Reproductive Health