Although someone can get pelvic inflammatory disease from using an intrauterine device (IUD), the risk is very low. The incidence is less than 1%.

The above information comes from a 2018 study.

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. The most common cause is untreated sexually transmitted infections (STIs), as 85% of cases stem from bacteria that spread during vaginal, anal, or oral sex.

However, in some cases, IUDs can contribute to PID. This usually happens shortly after insertion, and the risk generally disappears 3 weeks after IUD placement.

Read on to learn about the link between IUDs and PID, treatment options, prevention, and more.

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A person using an IUD has a slightly increased risk of PID. However, the likelihood usually disappears about 3 weeks after IUD placement.

The risk may stem from introducing bacteria from a cervix infection into the upper part of the female reproductive system. This can happen during an IUD fitting.

Although there is a risk of PID with IUD use, it is very low. Research states that the incidence is less than 1%.

Typically, an infection that spreads from the cervix causes PID. In 85% of cases, the infection comes from STI bacteria. Of the STI bacteria that can lead to PID, Neisseria gonorrhoeae or Chlamydia trachomatis are the most common. However, other microbes that reside in the cervix or vagina may also cause infection.

Aside from the risk factors of having an STI and using an IUD, douching also increases the likelihood.

Treatment is available for someone who receives an early diagnosis of PID, but it cannot reverse damage to the reproductive system that has already occurred. Therefore, the longer people wait to start treatment, the more likely they will have complications.

PID treatment consists of broad-spectrum antibiotics to cure the infection. In severe cases, hospitalization may be necessary.

Individuals also need to consider that if they contract another STI after receiving treatment for PID, they can develop PID again. This would require another round of treatment.

A person and their partner or partners should abstain from sexual intercourse until they complete treatment.

First-line outpatient treatment involves doxycycline (Adoxa)and ceftriaxone (Rocephin). Alternatively, a healthcare professional may recommend probenecid (Probalan) or another third-generation class of antibiotics called cephalosporins.

Inpatient treatment within a hospital setting is typically similar, but healthcare professionals may administer the drugs intravenously if a person experiences severe illness, vomiting, or a pelvic abscess. Medication options include:

  • cefotetan (Apatef) plus doxycycline (Adoxa)
  • cefoxitin (Mefoxin) plus doxycycline (Adoxa)
  • clindamycin (Cleocin) plus gentamycin (Garamycin)

In some cases, treatment may include metronidazole (Acea). This is a different type of antibiotic that doctors use to treat vaginal infections.

People can reduce their risk of STIs by using barrier method contraception and getting regular sexual health screenings. If a person seeks early medical attention for STIs, they can prevent PID.

Delayed treatment strongly relates to complications. These include:

  • Chronic pain: This links to adhesions, scarring, and inflammation from the infection.
  • Tubo-ovarian abscess: This is a pocket of pus that can develop in a fallopian tube or ovary. It occurs due to infection.
  • Infertility: Even PID that does not cause symptoms can result in infertility because the infection can severely damage parts of the female reproductive system.
  • Ectopic pregnancies: This is when a fertilized egg grows outside of the uterus. One study suggests that the rate is 7.8% following PID, which is considerably higher than the 1.3% rate in people without PID.

In addition to being a highly-effective, long-acting form of contraception, IUDs offer a range of benefits. Older research from 2014 reports the following:

  • The use is acceptable for individuals with multiple health conditions who are unsuitable candidates for other birth control methods.
  • IUDs reduce pelvic pain and menstrual blood loss in people with endometriosis, a condition where the uterine lining grows outside of the uterus.
  • The risks involved have a low incidence.
  • IUDs help protect against endometrium hyperplasia, a thickening of the uterine lining.
  • The effects of IUDs are reversible after removal.

It is possible to develop PID from IUD use, but the risk is very small. Most often, STIs are the cause.

Early treatment of PID with antibiotics is important to prevent permanent damage and complications, such as chronic pain and infertility. Anyone with symptoms of PID or an STI needs to speak with a doctor right away.