All of the following mechanisms might account for a reduce-risk of upper genital tract infection in users of progestin - releasing IUDs, except:
1.Reduced retrograde menstruation
2.Decreased ovulation
3.Thickened cervical mucus
4.Decidual changes in the endometrium
sol:
Several mechanisms account for a potential reduced risk of upper-genital-tract infection in users of progestin releasing IUDs.
First, the local effect of progestin on cervical mucus make it thick and relatively impenetrable to bacteria.
Since uterine bleeding is eventually greatly decreased in users of the LNG-IUD (progestin releasing IUD), any retrograde menstruation (which might seed the fallopian tubes with bacteria) should be reduced as well.
In addition, decidual changes in the endometrium may make it less susceptible to infection.
In other words, progestin-releasing IUDs may mimic the protective effect of combined oral contraceptives and depot medroxyprogesterone acetate against upper-genital-tract infection.
Also know:
PID is common in non hormonal IUCD.
IUCD related bacterial infections are due to contamination of endometrial cavity at the time of insertion.
Actinomycosis infection is related to IUCD use.
Most common side effect of IUCD’s is increased vaginal bleeding.
Contraception of choice in patients with current recent or recurrent PID is hormonal or barrier method: