Management of an IUD in a woman diagnosed with PID

IUD: intrauterine device; PID: pelvic inflammatory disease​; TOA: tubo-ovarian abscess.
* Refer to UpToDate content for more information on the diagnosis of PID, oral and parenteral treatment options, and indications for in-hospital treatment.
¶ Most women do not require IUD removal for treatment of PID. One exception is women who have actinomyces on cervical culture; these women are advised to have the IUD removed after initiation of antibiotics for PID.
Δ While the optimal time to remove the IUD after initiation of antibiotics is not known, it is common to wait 30 to 60 minutes, or until enough time has passed to establish an antibiotic serum level.
◊ Refer to UpToDate content on selecting contraception.
§ Clinical improvement includes reduction in pain and/or resolution of fever.
¥ Refer to UpToDate content on management of tubo-ovarian abscess.
‡ The optimal time for IUD insertion, if desired, following documented intrauterine infection is not known, although 12 weeks has historically been advised. Minimum criteria for IUD insertion include that the procedure be delayed until the treatment course is complete, the symptoms are resolved, and the cervical exam is normal. For more information, refer to the UpToDate topic on management of IUD complications and side effects.