REPRODUCTIVE TRACT INFECTIONS AND DISORDERS

_

  = Use the method

_

  = Do not use the method

I

  = Initiation of the method

C

  = Continuation of the method

  = Use the method

NA

  = Not applicable

Condition

Combined oral contraceptives Monthly injectables Combined patch and combined vaginal ring Progestin-only pills Progestin-only injectables Implants Emergency contraceptive pills* Copper-bearing intrauterine device Levonorgestrel intrauterine device Female sterilization*
REPRODUCTIVE TRACT INFECTIONS AND DISORDERS
Vaginal bleeding patterns   I C  
Irregular pattern without heavy bleeding 1 1 1 2 2 2 1 1 1 A
Heavy or prolonged bleeding (including regular and irregular patterns) 1 1 1 2 2 2 2 1 2 A
Unexplained vaginal bleeding (suspicious for serious condition), before evaluation 2 2 2 2 3 3 I C I C D
4 2 4 2
Endometriosis 1 1 1 1 1 1 2 1 S
Benign ovarian tumors (including cysts) 1 1 1 1 1 1 1 1 A
Severe dysmenorrhea 1 1 1 1 1 1 2 1 A
Trophoblast disease  
ß-hCG regression 1 1 1 1 1 1 3 3 A
ß-hCG elevationg 1 1 1 1 1 1 4 4 D
Cervical ectropion 1 1 1 1 1 1 1 1 A
Cervical intraepithelial neoplasia (CIN) 2 2 2 1 2 2 1 2 A
Cervical cancer (awaiting treatment) 2 2 2 1 2 2 I C I C D
4 2 4 2
Breast disease  
Undiagnosed mass 2 2 2 2 2 2 1 2 A
Benign breast disease 1 1 1 1 1 1 1 1 A
Family history of cancer 1 1 1 1 1 1 1 1 A
Breast cancer  
Currentg 4 4 4 4 4 4 1 4 C
Past, no evidence of disease for at least 5 years 3 3 3 3 3 3 1 3 A
Endometrial cancerg 1 1 1 1 1 1 I C I C D
4 2 4 2
Ovarian cancerg 1 1 1 1 1 1 3 2 3 2 D
Uterine fibroids  
Without distortion of the uterine cavity 1 1 1 1 1 1 1 1 C
With distortion of the uterine cavity 1 1 1 1 1 1 4 4 C
Anatomical abnormalities  
Distorted uterine cavity 4 4
Other abnormalities not distorting the uterine cavity or interfering with IUD insertion (including cervical stenosis or lacerations) 2 2
Pelvic inflammatory disease (PID)  
Past PID (assuming no current risk factors for STIs)   I C I C  
With subsequent pregnancy 1 1 1 1 1 1 1 1 1 1 A
Without subsequent pregnancy 1 1 1 1 1 1 2 2 2 2 C
Current PID 1 1 1 1 1 1 4 2m 4 2m D
Sexually transmitted infections (STIs)g   I C I C  
Current purulent cervicitis, chlamydia, or gonorrhea 1 1 1 1 1 1 4 2 4 2 D
Other STIs (excluding HIV and hepatitis) 1 1 1 1 1 1 2 2 2 2 A
Vaginitis (including trichomonas vaginalis and bacterial vaginosis) 1 1 1 1 1 1 2 2 2 2 A
Increased risk of STIs 1 1 1 1 1 1 2/3n 2 2/3n 2 A

m Treat PID using appropriate antibiotics. There is usually no need to remove the IUD if the client wishes to continue use.

n The condition is category 3 if a woman has a very high individual likelihood of exposure to gonorrhea or chlamydia.

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