Rumor 1 about IUDs :-IUDS cause pelvic infection -This is a myth-Let us see the fact .

31.     Prevalence & How best to tackle  Pelvic infection (PID-Pelvic inflammatory disease):

            Female genital organs are arbitrarily divided into two compartments e.g. lower genital tract and upper genital tract comprises of external genitalia (vulva) and birth canal (Vagina). The upper genital tract comprises of womb (uterus and its mouth i.e. cervix), fallopian tubes, with i.e. egg transport tube which carries eggs from egg relasing organ (ovaries) to womb.

PID is the infection of upper genital organs. The abbreviation ‘P.I.D.’ stands for ‘Pelvic Inflammatory Disease’. There are many organisms responsible for PID. Some organism responsible for sexually transmitted diseases can also cause PID. Poor hygiene, under-nutrition, pelvic tuberculosis and above all repeated induced abortions can initiate PID. Abortion can procedure even if carried by experts in a clean environment can result PID. So surgical abortion is not cent percent safe and should be avoided as far as possible. The long term ill effects of PID are chronic pelvic pain.

Low backache. Infertility or pregnancy in fallopian tube, i.e. ectopic pregnancy. The very anatomy of fallopian tube and crypts in cervix are such that any infection in these areas is difficult to cure by drugs surgery permanent.

Coming to the question of whether IUD inserted inside the womb will invite PID or not was a debatable issue. Opinion of scientists still vary people have different views. In the decades of seventies and eighties both reproductive scientists as well as acceptors of IUD firmly believed that the risk of genital infection will remain high during the entire period of IUD wearing. In the 1992 international conference on IUD critically analyzed the review published by WHO which was Meta analysis (summary of many studies analyzed together) involving nearly 22, 908 IUD users (using a total of 10 different IUD types) around the world. Result of that review supports the relative safety of IUD use so far as PID is concerned. All the researchers unanimously and firmly concluded that copper IUDs do not promote PID.

            Meta analysis also point that PID rates were highest among young IUD users in certain geographic regions. PID rates were high among IUD users in Africa and lowest in China were bilateral monogamy is the usual rule.

The observers who were in charge of analyzing such data finally concluded that much of the IUD associated PID occurs in women who are at higher risk of STD infection, i.e. primarily women with more than one sexual partner or whose partner has other sexual partner.

To summaries on the issue of IUD induced PID’ it may be inferred  that a) overall, the rate of PID among IUD users was very low (1.6 cases per 1,000 woman years of use) b) the rate of PID was highest during the first twenty days after insertion (9.7 cases per 1,000 insertion) and remains low and stable thereafter (0.5 to 1.4 cases per 1,000 woman years of use) c) some physicians employ preventive antibiotics before inserting the IUD, but the meta analysis did not find that this was helpful. d) twenty days after insertion of IUD the risk of PID remain very low, even among users who had an IUD in place for eight years or more. In the event the woman develops evidence of genital infection (P.I.D.) while on IUD it is not necessary to remove IUD. Instead potent antibiotics should be prescribed in consultation with HCP. Removal of the device during the infection does not ameliorate her symptoms or modify the course of PID in any way. IUD, however can be removed if the client so demands or if evidences of infection do not subside in spite of adequate treatment for reasonable period of time.