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Cesk Gynekol. 1978 Jul;43(6):447.

[Which stage of the menstrual cycle in best suited for the insertion of IUD?].

[Article in Czech]



Some clinicians feel that the best time for inserting an IUD is during a woman's menstrual period. At that time the cervix is dilated, the chance of introducing an IUD into a pregnant uterus is slight, and the menstrual bleeding masks bleeding due to insertion. There is evidence that inserting the IUD during the menstrual period lowers the incidence of infection, spontaneous expulsion, and removal due to method failure and patient dissatisfaction. But there are clinicians who freely insert the IUD at other times in the cycle. This may be particularly advantageous in developing countries, where a woman who has had to travel a great distance to the family planning clinic but arrives when she is not menstruating might not return at another time. The IUD may also be inserted after unprotected coitus as a "morning after" contraceptive. The International Planned Parenthood Federation conducted a world-wide study to determine what stage of the cycle IUDs are being inserted. 33% of the 240 respondents insert the IUD only during the woman's period, and 70% of them do so only because their clinic requires it. 49% of the respondents from Africa and the Middle East, 30% of the respondents from Europe and the U.S., and 13% of the respondents from Asia restrict insertion to this time. Of the 67% of respondents who said they insert the IUD when the woman is not menstruating, most restrict insertions to 10 days after the last menstrual period. Most cite the possibility of pregnancy as the reason for this practice. The percentage of clinicians willing to insert the IUD at any point in the cycle varies with the contraceptive method the patient is using. Only 7% are willing to do this for women who use no contraception, 18% for women who use non-hormonal contraception, and 36% for women who were using oral contraceptives.

[Indexed for MEDLINE]

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