To reduce the risk of infection, insertion of an IUD is not recommended for women that have had a medical abortion but have not yet had an ultrasound to confirm that the abortion was complete, or that have not yet had their first menstruation following the medical abortion.A full list of contraindications can be found in the WHO Medical Eligibility Criteria for Contraceptive Use and the CDC United States Medical Eligibility Criteria for Contraceptive Use. Side effects
Irregular menstrual pattern: irregular bleeding and spotting is common in the first three to six months of use. After that time periods become shorter and lighter, and 20% of women stop having periods after one year of use. The average user reports 16 days of bleeding or spotting in the first month of use, but this diminishes to about four days at 12 months. Cramping and pain: many women feel discomfort or pain during and immediately after insertion. Some women may have cramping for the first 1–2 weeks after insertion. Expulsion: Sometimes the IUD can slip out of the uterus. This is termed expulsion. Around 5% of IUD users experience expulsion. If this happens a woman is not protected from pregnancy. Expulsion is more common in younger women, women who have not had children, and when an IUD is inserted immediately after childbirth or abortion. Perforation: Very rarely, the IUD can be pushed through the wall of the uterus during insertion. Risk of perforation is mostly determined by the skill of the practitioner performing the insertion.
Ovarian cysts: Enlarged follicles (ovarian cysts) have been diagnosed in about 12% of the subjects using a hormonal IUD in studies that use ultrasound to look for cysts, even if asymptomatic. In studies that only evaluate symptomatic cysts, only 4.5% of women complain of any ovarian cysts over 5 or more years of use, and only 0.3% require IUD removal for ovarian cysts. Thus, any issues with ovarian cysts are not of a clinically relevant nature. Most of these follicles are asymptomatic, although some may be accompanied by pelvic pain or dyspareunia. In most cases the enlarged follicles disappear spontaneously after two to three months. Surgical intervention is not usually required. Mental health changes including: nervousness, depressed mood, mood swings
Weight gain
Headache, migraine
Nausea
Acne
Excessive hairiness
Lower abdominal or back pain
Decreased libido
Itching, redness or swelling of the vagina
Vaginal discharge
Breast pain, tenderness
Edema
Abdominal distension
Cervicitis
Bacterial vaginosis
May affect glucose tolerance
May experience a change in vision or contact lens tolerance
May deplete vitamin B1 which can affect energy, mood, and nervous system functioning
A "lost coil" occurs when the thread cannot be felt by a woman on routine checking and is not seen on speculum examination. Various thread collector devices or simple forceps may then be used to try to grasp the device through the cervix. In the rare cases when this is unsuccessful, an ultrasound scan may be arranged to check the position of the coil and exclude its perforation through into the abdominal cavity or its unrecognised previous expulsion.