Ask the client the Medical Eligibility Criteria questions for Copper-Bearing IUDs . Also ask the questions below about known medical conditions. If she answers “no” to all of the questions here and for the copper-bearing IUD, then she can have an LNG-IUD inserted if she wants. If she answers “yes” to a question, follow the instructions. In some cases she can still have an LNG-IUD inserted.
1. Did you give birth less than 4 weeks ago?
No
Yes - she can have the LNG-IUD inserted as soon as 4 weeks after childbirth (see When to start).
2. Do you now have a blood clot in the deep veins of your legs or lungs?
No
Yes - if she reports current blood clot (except superficial clots), help her choose a method without hormones.
3. Do you have severe cirrhosis of the liver, a liver infection, or liver tumor? (Are her eyes or skin unusually yellow? [signs of jaundice])
No
Yes - if she reports serious active liver disease (jaundice, active hepatitis, severe cirrhosis, liver tumor), do not provide the LNG-IUD. Help her choose a method without hormones.
4. Do you have or have you ever had breast cancer?
No
Yes - do not insert the LNG-IUD. Help her choose a method without hormones.
For complete classifications, see Medical Eligibility Criteria for Contraceptive Use. Be sure to explain the health benefits and risks and the side effects of the method that the client will use. Also, point out any conditions that would make the method inadvisable, when relevant to the client.
Using Clinical Judgment in Special Cases
Usually, a woman with any of the conditions listed below should not use an LNG-IUD. In special circumstances, however, when other, more appropriate methods are not available or acceptable to her, a qualified provider who can carefully assess a specific woman’s condition and situation may decide that she can use an LNG-IUD. The provider needs to consider the severity of her condition and, for most conditions, whether she will have access to follow-up.
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Less than 4 weeks since giving birth
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Current blood clot in deep veins of legs or lungs
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Had breast cancer more than 5 years ago, and it has not returned
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Severe liver disease, infection, or tumor
See also Copper-Bearing IUD, Using Clinical Judgment in Special Cases.
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