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7) Who CAN and CAN’T Use an IUD? (Talking IUC with Dr. D) 

Dr. Kristina Dervaitis
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IMPORTANT 2023 UPDATE re: IUD DURATION OF USE- US FDA now approves 52mg levonorgestrel IUD (Mirena, Liletta) for 8 YEARS use for contraception. When treatment of heavy menstrual bleeding is the primary indication, best results are usually seen in the first 5 years. Kyleena (19.5mg) is still 5 years. See video #35 for info on copper IUD extended use.
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Dr. Kristina Dervaitis, an OB/Gyn in Newmarket, Ontario, answers your IUD questions:
Who CAN use an IUD? Who CANNOT or should not use an IUD? What are some of the “myths” surrounding who can or can’t use an IUD?
CAN use an IUD:
(Addressing some IUC myths/misconceptions)
-patients who have never had children
-adolescents
-have not yet been sexually active
-past history of STI (successfully treated)
-women who are breastfeeding
-past history of a blood clot (or at increased risk of blood clot)
CANNOT use an IUD:
(ABSOLUTE CONTRAINDICATIONS):
-already pregnant
-active pelvic infection
-recent septic (infected) miscarriage
-known distorted uterine cavity
-abnormal uterine bleeding not yet diagnosed/ investigated
-cancer of the uterus or cervix
-gestational trophoblastic disease
-progesterone receptor positive breast cancer (re: hormonal IUD)
-pelvic tuberculosis
CANNOT (or probably cannot) use an IUD:
(RELATIVE CONTRAINDICATIONS):
-treated (previous) progesterone receptor positive breast cancer (re: hormonal IUD)
-some liver diseases (re: hormonal IUD)
-complicated solid organ transplant
-between 48 hours and 4 weeks post partum
Please note: this channel is provided as a volunteer public health education initiative (not for profit, no industry support, the channel is not monetized with ads). Dr. Dervaitis received her MD in 2000 and completed her OB/Gyn residency training in 2005 at Western University.
For more information, I recommend the official sexual health website of the Society of Obstetricians and Gynaecologists of Canada: www.sexandu.ca

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17 ноя 2018

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Комментарии : 70   
@dawnreed6229
@dawnreed6229 4 года назад
Your various eyewares are awesome 🤓
@belachewwubetu5550
@belachewwubetu5550 4 года назад
thank you Dr,all of your videos are helpful for me as a medical student
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
You’re welcome! I’m glad you found them useful! Tell your other med student friends about my channel, and also your family medicine and Gynecology professors too! 😊Dr. Dervaitis
@MilyTheSHark
@MilyTheSHark 4 года назад
I have hypothyroidism and am on medication for it. However, whenever I’m on any hormonal birth control it makes me symptomatic again. I tried a hormonal IUD, and though the hormones entering the bloodstream are low, it still made me symptomatic again. The non hormonal Copper IUD is the only BC that has worked for me! Thought I’d share just in case anyone else is going through this! There is still a good BC option :)
@dr.kristinadervaitis789
@dr.kristinadervaitis789 5 лет назад
Thanks for your comment! I’m sure your doctor will help you find the IUD that’s right for you, after considering your medical and menstrual history. I will say that “other body” (systemic) hormone side effects (like mood changes) are RARE with The levonorgestrel IUD. The hormone is delivered to the uterine lining and very little actually gets into the blood stream (so it’s much different than taking a hormone orally as a pill). (I laughed when you mentioned my glasses, it’s sort of my “thing”- for some it’s shoes or purses, for me it’s glasses! Lol) Good luck! -Dr. Dervaitis
@alicec.6195
@alicec.6195 4 года назад
Thank you very much for adding info about people with history of blood clot!! I've had it and I find so hard to get any information about it. I've recently had a copper IUD inserted (4 days ago) and so far so good, not even bleeding anymore.
@universezero2590
@universezero2590 3 года назад
Hi have you continued to use this method of IUD if not what has helped please and thanks 😊
@elwood10198
@elwood10198 3 года назад
Enormous thank you for providing such informative videos to enable women to make more informed decisions about IUD's. I'm 48 and considering Kyleena or Mirena predominantly for heavy periods, last one was 20 days long. I'm a nulligravida, family history of breast cancer, but I personally tested BRACA2 Negative, I just want lighter periods with the least side effects (realistically possible), so you are giving me hope. I'm going to watch your other videos to find out more, including your opinion on the best pain relief for insertion, in your opinion. Two medical facilities locally don't use local anaesthetic or numbing cream for insertion.
@dr.kristinadervaitis789
@dr.kristinadervaitis789 3 года назад
Hello- Glad you have found the videos helpful! I think I address the issue of “pain relief” at insertion in video #6, but briefly: individual practices vary. I personally do not use any anesthetic sprays or injections because there is not any consistent or convincing evidence to show that it makes a significant difference in terms of improving pain ((in some instances, a patient might find the process of injecting freezing into the cervix with a needle more painful than the insertion itself...) -Dr. Dervaitis
@elwood10198
@elwood10198 3 года назад
@@dr.kristinadervaitis789 Thank you very much indeed for your message. If most women use OTC painkillers and it's only 15 seconds of pain, I think I should just go for it. I heard someone else say an injection in the cervix is worse than an IUS insertion, the agreement adds weight to that. Once again enormous thank you for your videos, they are so helpful, for a number of reasons. They save so much time when in consultation with a doctor when we have some knowledge already.
@casebeth
@casebeth 4 года назад
so the tilted uterus excuse that one gyno gave me is BS? She never even took an ultrasound to try that method of guiding it in. I feel like I was just screwed over
@honeyblondedreads7275
@honeyblondedreads7275 5 лет назад
Glad I found your videos. Very informative. Everyone with a video out had a bad experience with it etc... I was told due to my age and weight , pills may not be an option for me anymore. So doctor suggested the iud. I'm just not sure which way to go. I'm more scared of how I will feel long term. Wanna feel normal not weird/moody etc .. And I like how you wear different glasses in each video.
@universezero2590
@universezero2590 3 года назад
Hi did you end up trying the IUD if not what did you try if anything thanks 😊
@honeyblondedreads7275
@honeyblondedreads7275 3 года назад
@@universezero2590 Hey! And no i didn't go through with it.. choose to do w/o because i noticed after i stop taking pills my reoccurring yeast problems went away. Plus i haven't been active in 3 years(tmi)..lol.
@narjisab9083
@narjisab9083 4 года назад
Hi, can you advise on what options are available for women with high blood pressure and who also smoke? I was considering tubal ligation but after researching it I don't think that's something I want to go through. I'm 37 and have 3 children which led to terrible pre-eclampsia and I'm positive I do not want anymore. I also do not want surgery. Any advice or direction to a video I might have missed would be wonderful. Thank you for taking the time to provide these very informative videos 👍
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
In smokers >35 or any patient with hypertension, we would want to AVOID any estrogen containing contraception (eg. the combined birth control pill). However, all progesterone only options (the progesterone only pill, depo Provera shot, hormonal IUD, implant) are still possible to use here. I recommend that you talk to your doctor about the hormonal IUD (Mirena or Liletta). The copper IUD is also possible, but usually causes heavier more painful periods (the hormonal dies the opposite). -Dr. Dervaitis
@narjisab9083
@narjisab9083 3 года назад
@@dr.kristinadervaitis789 thank you for your response. I talked with the Dr. And was prescribed a new progesterone on pill called SLYND. Do you have any information about this medication? Since it's so new it's hard to find a lot of data on it. I've been taking it for almost 3 weeks and so far so good. I would like to have some background on it though and know what side effects I may anticipate. Thanks again for your help
@dr.kristinadervaitis789
@dr.kristinadervaitis789 3 года назад
Sorry, not familiar with that particular pill. (Have never heard of it, it might not be available in Canada?) -Dr. Dervaitis
@cheryl370
@cheryl370 2 года назад
I had a uterine rupture during labor and delivery along with a ureter tube rupture. This was a little over 20 years ago. With these kinds of complications is it still possible to have a Mirena IUD? I am peri menopausal with heavy painful periods. Thickened endometrial lining.
@dr.kristinadervaitis789
@dr.kristinadervaitis789 2 года назад
Previous uterine rupture is not a contraindication. Patients with previous trauma and healing of the uterus (whether it be a rupture or c-section incision) are able to use an IUD. -Dr. Dervaitis
@granpasquatch6092
@granpasquatch6092 3 года назад
What if you have thin blood disorder and they told you to get the liletta ( estrogen) IUD? is that harmfull? along with previous family history of blood clotting? and heart issues?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 3 года назад
Liletta does not contain estrogen (it is progesterone). It is fine to use in patients regardless of any blood disorder (“thick” or “thin”). Family history of blood clotting or heart issues is not a contraindication. -Dr. Dervaitis
@matildemeini660
@matildemeini660 11 месяцев назад
By using the Nuvaring i got a yeast infection 6 times, will this happen with the IUC because of the strings?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 10 месяцев назад
No association between IUD use and yeast infections.
@traceydemarco9365
@traceydemarco9365 4 года назад
I’m getting the Mirena due to extremely heavy and very frequent periods. I can’t take the pill because it makes me really sick. (Nauseous, vomiting, dizziness) should I get the Mirena since I’m so sensitive to the pill?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Please see video #14 (IUD vs. the Pill), video #10 (Possible hormonal side effects) and videos #19 and 20 (about treating heavy, painful periods with the Levonorgestrel IUD). All the best, -Dr. Dervaitis
@markrodriguez6073
@markrodriguez6073 4 года назад
Dr. My girlfriend is a kidney/ pancreas transplant recipient. Her transplant took place a little over a year ago. She has had no complications with her new organs. Would she be considered a candidate for a Mirena IUD?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Hello- Having had a previous transplant (of any organ) is not a contraindication to IUD use. In any immune compromised patient (eg. someone taking anti-rejection medication) we would be very cautious to watch for any signs of infection after insertion (the overall risk is low, and if it were to occur, it typically would be in the first 20 days after insertion). But definitely Mirena is still a possibility in transplant recipients (appropriate contraception is critical in these patients where an unplanned pregnancy would not be ideal). As always, I’d advise that the patient discuss this further with their own doctor. All the best, Dr. Dervaitis
@markrodriguez6073
@markrodriguez6073 4 года назад
Dr. Kristina Dervaitis thank you so much Dr. D. For your prompt response. Your videos are very informative and insightful. I will relay this to her. We just want to keep her safe and infection free. All the best
@Rebeltopia1111
@Rebeltopia1111 4 года назад
I like your videos, you are very informative and I greatly appreciate that I had these videos to refer to. I couldn't help but, to notice and consistently pay attention to that fact, you never look into the camera and it feels more like you are reading to us, rather than teaching/talking. I'm not being mean or saying it is a bad thing, it just personally felt, "off" to me and made it harder for me to fully engage with the information.
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Hi- I appreciate your constructive comments. The funny thing is, the only video that was “scripted” (where I was actually reading...) was video #1. For the rest, I am just talking spontaneously (no script) with only an outline written. I am new to all of this (the videos for this channel were the first things I ever posted online!) I make these videos with my iPhone propped up on top of a stack of textbooks on my desk, so it it certainly not a professional filming set up! I will try to find a way to look at a better angle into the phone screen maybe? Hopefully, the facts and the overall messages are conveyed to viewers regardless. -Dr. Dervaitis
@shreelatagajul8249
@shreelatagajul8249 4 года назад
Hi doctor.Thank you very much for your videos.I had mirena IUD 4 months ago after polypectomy. I am facing irregular spotting ,so my doctor prescribed medicines like regestrone and trenaxa. Can you tell how much time it will take for regular menstrual cycle.
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Hello- Unfortunately I can’t give personalized medical advice over the internet, and there is really no way for me to predict your menstrual bleeding in this situation. I’d recommend that you go over your questions with your doctor. -Dr. Dervaitis
@vaidikpatel123v
@vaidikpatel123v 4 года назад
Hey Dr. Kristina, I have been researching IUDs for class and have seen multiple sources including ACOG, WHO, and the manufacturer guidelines they say that having “multiple sexual partners” is a contraindication to using the L and C IUD. Why is that?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Hi- That concept is archaic and mostly to do with infection concerns with the (very!) old IUD from decades ago. In fact, patients with multiple sexual partners are at higher risk of unplanned pregnancy (because they tend to be more sexually active) and definitely should consider an IUD- they just need to be sure to always also use condoms with a new partner to prevent STI’s! Great question! Thanks for watching!👍 -Dr. Dervaitis
@vaidikpatel123v
@vaidikpatel123v 4 года назад
Dr. Kristina Dervaitis thank you! I appreciate you answering my question.
@user-pu7ti4zj4h
@user-pu7ti4zj4h 3 года назад
Is it okay to have an iud when you have frequent candida infections due to antibiotic use (antibiotics are needed for chronic lung condition)?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 3 года назад
Yes. No increased risks in the context of yeast infections (and note that the use of an IUD does not increase the incidence of yeast infections). -Dr. Dervaitis
@Handleyoutube333
@Handleyoutube333 10 месяцев назад
What age can you use an iud till? I’m 52 and have had the Mirana for last 20 years ?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 10 месяцев назад
No age limit! Many women continue to have periods into their late 50’s. There are also some (off label) indications for use in post menopausal women. -Dr. Dervaitis
@dearbornpop
@dearbornpop Год назад
Dr. D, I had an hormonal IUD inserted a month ago and was wondering if there is increased risk for breast cancer with an IUD? Idk if I’m sensitive to hormones, is that something my doctor’s office can test?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 Год назад
No definitive evidence to link the hormonal IUD to breast cancer. There is, however, evidence linking it to DECREASED rates of uterine and ovarian cancer. -Dr. Dervaitis
@Sorrell2046
@Sorrell2046 5 месяцев назад
So progesterone only iud ok for previous estrogen positive breast cancer?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 5 месяцев назад
This channel is not intended to provide personalized medical advice. Talk to your doctor.
@LadyBeige
@LadyBeige 3 года назад
I used to get anxiety from the nexplanon implant☹️ do you think my only option left would be the copper iud?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 3 года назад
This channel is not intended to provide personalized medical advice. See video #10 and video #11 for more information that might help you with your decision. -Dr. Dervaitis
@DebRoo11
@DebRoo11 8 месяцев назад
​@@dr.kristinadervaitis789i think commenting on possible anxiety/depression side effects to both types of IUDs is reasonable and not medical advice. I'd like to know possibke mood side effects as well
@gabyramirez4832
@gabyramirez4832 2 года назад
My doctor said my uterus looked inflamed and she sounded like she wasn’t sure whether to insert the merena. I asked her if everything was ok and she said,” your uterus looks inflamed nothing serious but it looks irritated.” However she did insert the iud. So now that I’ve had it for 3 months I’m now questioning myself about having it inserted with the comment she said and you said it’s a no if it’s inflamed. Should I schedule a check up with my doctor? I’m worried now
@dr.kristinadervaitis789
@dr.kristinadervaitis789 2 года назад
If there is going to be an infection related to the IUD insertion, it usually occurs in the first 3 weeks. If you are outside of this timeframe without complications, there should be no concern about the “inflamed” commentary. (But if you are worried, talk to your doctor). -Dr. Dervaitis
@TheMusesOrg
@TheMusesOrg 3 года назад
I'm not convinced the doctors who decided I needed the Mirena to help my heavy periods fully investigated or determined the cause of my bleeding. I was given a hysteroscope, D&C and Mirena all at the same time and was out the door the same day. They also told me to stop the high dose of Primolut N I'd been relying on to control the bleeding pretty much cold turkey the day of insertion (I later read that Mirena doesn't start working until after a week of insertion). I feel like I've been losing my mind the past few days (my mood has been all over the place) and the bleeding (with clots) has been increasing. I'm happy to have the Mirena and I very much hope it works for me, but I'm scared I've been given bad advice and will expel it at some point due to the bleeding.
@schaeannsalmon
@schaeannsalmon Год назад
Are u still using it ? Whats happened since this post?
@TheMusesOrg
@TheMusesOrg Год назад
@@schaeannsalmon Hi, are you asking because you're in a similar situation? As I predicted, I did end up expelling it around a week after the procedure (encased in a giant clot - sorry for TMI). I tried letting the staff at the hospital know what happened but I feel like they just fobbed me off, so I think they knew they messed up. Don't let my story put you off if you're thinking of getting one though, my situation was not typical. Turns out the heavy bleeding was due to endometrial cancer and I have since had a full hysterectomy/radiation therapy. Happy to not be bleeding to death any more!
@schaeannsalmon
@schaeannsalmon Год назад
@@TheMusesOrg its what was recommended by my doc and im researching the options given so yes im contemplating
@schaeannsalmon
@schaeannsalmon Год назад
@@TheMusesOrg im sorry to hear that happened to you :(
@zainabsufy11130zainab
@zainabsufy11130zainab 2 года назад
Please I have IUD in me but my husband is traveling 🧭 at the time am on my period can I take contraceptive pill’s to stop the blood 🩸 please I need an urgent answer 🙏
@dr.kristinadervaitis789
@dr.kristinadervaitis789 2 года назад
Yes, the birth control pill can be used concurrently with the IUD to manage bleeding (if it is a hormonal IUD, usually the birth control pill is used only for a limited period of time for this purpose). -Dr. Dervaitis
@zainabsufy11130zainab
@zainabsufy11130zainab 2 года назад
@@dr.kristinadervaitis789 thanks so much Dr Kristina Dervaitis😘
@veronicabelgarde4037
@veronicabelgarde4037 Год назад
What about abnormal Pap smears?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 Год назад
Pap test abnormalities are not a contraindication to IUD use. The investigation and management of pap abnormalities can continue even with an IUD in place. (However, note that actual cervical cancer is a contraindication to IUD insertion). -Dr. Dervaitis
@AngieLolaPagan
@AngieLolaPagan 2 года назад
Can I get an iud if I have been diagnosed in the past during pregnancy with incompetent cervix ?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 2 года назад
Yes. Previous cervical incompetence is not a contraindication (and does not increase risk of expulsion). -Dr. Dervaitis
@jomarvelez7099
@jomarvelez7099 2 года назад
Can a partial septate uterus have a IUD ?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 2 года назад
There are not definitive studies to address this in particular, but I can say that in my practice I still prescribe HORMONAL IUD’s (not copper) to patients with partial septate or arcuate uteri. (The mechanism of action of the hormonal IUD is based more on hormone release and not precise position within the uterus). Decision making around this issue would be dependent on imaging and each particular case is unique. -Dr. Dervaitis
@annacobos7944
@annacobos7944 4 года назад
Is Mirena Iud appropriate for uteral polyp treatment?
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Hi Anna- Great question! I’ve been meaning to do a video about the levonorgestrel IUD and polyps... The answer is “yes”- Mirena has been shown to decrease uterine polyps. In some situations, it might be necessary to surgically remove a polyp (especially very large polyps, or polyps in post menopausal women). But not all polyps require surgery (or any treatment at all). If a patient is having bothersome bleeding, the Mirena might be an ideal treatment option. -Dr. Dervaitis
@zakarrahgraves9191
@zakarrahgraves9191 5 лет назад
I got Mirena iud in October and 2018
@nadianady9964
@nadianady9964 3 года назад
Hello i'm 18 yrs old and i have a question for you. When i have sex i just feel when the penis pushes my cervix, would it be a problem for The iud? Can it cause damage or can the iud move inside? I considered to use an iud but no dr. helped me with this question Thank you very much for your videos
@dr.kristinadervaitis789
@dr.kristinadervaitis789 3 года назад
It absolutely would still be ok to consider an IUD- it’s not uncommon for the penis to come into contact with the cervix during intercourse, and this does not cause problems with the IUD which is well protected and stable inside the uterus (this would not cause the IUD to shift). -Dr. Dervaitis
@nadianady9964
@nadianady9964 3 года назад
@@dr.kristinadervaitis789 thank you so much! Your answer helped me a lot!
@dr.kristinadervaitis789
@dr.kristinadervaitis789 4 года назад
Hi Liza- The hormonal IUD would only be contraindicated if YOU yourself had an active case of breast cancer. Family history is not a contraindication. To date, there is not consistent or definitive evidence linking the hormonal IUD to breast cancer. -Dr. Dervaitis
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Просмотров 12 тыс.