An intrauterine device (IUD) is a small, T-shaped device inserted into the uterus that provides highly effective, long-term contraception. Concerns about infection are common for people considering an IUD. While the risk is real, it is specifically tied to the insertion process rather than the device itself over the long term. Understanding the nature and timing of this risk can help potential users make informed decisions.
The Critical Window of Infection Risk
The elevated risk of infection associated with IUD placement is concentrated in the immediate period following the procedure. Data shows that the chance of infection is highest during the first 20 days after insertion. This temporary increase occurs because the insertion process can mechanically push bacteria from the vagina and cervix up into the sterile environment of the uterus. The device itself does not typically cause infection once it is properly seated. After this initial three-week period, the infection risk returns to the baseline level seen in the general population. This short-term risk is why healthcare providers emphasize sterile technique during the procedure.
Understanding Pelvic Inflammatory Disease
The primary infection concern related to IUD insertion is Pelvic Inflammatory Disease (PID), which is an infection of the upper reproductive organs, including the uterus, fallopian tubes, and ovaries. PID is most often caused by a pre-existing or recently acquired sexually transmitted infection (STI), such as chlamydia or gonorrhea. These STI-causing bacteria account for the majority of PID cases. If an STI is present and untreated at the time of insertion, the procedure can act as a vehicle, providing a pathway for the bacteria to travel upward from the cervix. Untreated PID can result in serious complications, including chronic pelvic pain, tubal factor infertility, and an increased risk of ectopic pregnancy due to scarring.
Screening and Risk Mitigation Before Placement
Healthcare providers actively manage the infection risk through proactive screening and careful technique. Before placing an IUD, a provider will typically conduct a risk assessment for STIs, especially for individuals under 25 or those with risk factors like multiple or new sexual partners. Screening tests for gonorrhea and chlamydia are often performed to identify and treat any hidden infections. If a patient is considered high-risk, providers may perform STI testing on the same day as the scheduled insertion. Current medical guidelines state that insertion should not be delayed while awaiting test results, though the procedure is contraindicated if a patient presents with active purulent cervicitis.
Recognizing Signs of Infection Post-Insertion
Knowing the signs of a potential infection is important for all IUD users, particularly in the weeks following placement. While some cramping and light bleeding are normal post-insertion, symptoms that suggest an infection warrant immediate medical attention. These symptoms include severe or worsening lower abdominal or pelvic pain. Other signs of concern include an unexplained fever, often accompanied by chills, or a noticeable change in vaginal discharge. Discharge that is unusually heavy, has a foul odor, or appears purulent can indicate an infection. Pain experienced during sexual intercourse or during a pelvic exam should prompt a call to a healthcare provider.