Italian guidelines on the effective and appropriate use of intrauterine contraception

Several women and doctors are doubtful regarding the use of intrauterine systems (IUS) releasing levonorgestrel and intrauterine devices, due to the limited information about its specific indications and contraindications. The goal of these “guidelines” is to provide informations based on up-to-date scientific evidences regarding intrauterine contraception. Main recommendations are the following: •the intrauterine contraception may be considered as first choice in most women including nulliparous women and adolescents; •the risk of pelvic inflammatory disease associated with the use of intrauterine contraception is low (about 1.6 per 1000 women/ year) and the pathogenesis of the infection appears to be linked to the insertion procedure; •a selective testing for infectious diseases based on individual risk factors is preferable to a test involving all women; •women at higher risk should be tested before insertion or at the time of insertion; •routine use of antibiotics before insertion is not recommended: women at high risk of asymptomatic sexually transmitted infections should be tested and, if positive, treated; •a post insertion ultrasound evaluation is not required.