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  • Title: Intrauterine devices and pelvic inflammatory disease: recent developments.
    Author: Grimes DA.
    Journal: Contraception; 1987 Jul; 36(1):97-109. PubMed ID: 3311628.
    Abstract:
    The potential relationship between use of intrauterine devices and pelvic inflammatory disease is one of the most important issues in contraception today. A number of large, sophisticated studies published since mid-1980 have clarified this association. All have consistently revealed an increased risk of pelvic inflammatory disease among intra-uterine device users, but the most objective of these studies indicate a relative risk compared to women using no method (1.5-2.6) lower than previous estimates. For most intrauterine device wearers, the increased risk of pelvic inflammatory disease persists for only a few months after insertion. The Dalkon Shield appears associated with a higher risk of pelvic inflammatory disease than the Lippes Loop, Saf-T-Coil, or copper devices. Careful selection of candidates for intrauterine devices may further reduce the risk of intrauterine device-associated pelvic inflammatory disease. The potential relationship between use of IUDs and pelvic inflammatory disease (PID) is one of the most important issues in contraception today. A number of large sophisticated studies published since mid-1980 have clarified this association. All have consistently revealed an increased risk of PID among IUD users, but the most objective of these studies indicate a relative risk compared to women using no method (1.5-2.6) lower than previous estimates. For most IUD users, the increased risk of PID persists for only a few months after insertion. The Dalkon Shield appears associated with a higher risk of PID than the Lippes Loop, Saf-T-Coil, or copper devices. Taken together, these studies suggest that IUD use carries a small but real risk of PID that is attributable to endometrial contamination at the time of insertion. Careful selection of candidates for IUD use--white women aged 25 years or over who have only 1 sexual partner--can reduce this risk.
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