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Could my patient's pain during intercourse be due to her ParaGard IUD? #1207/10

Hello Dr. Hatcher:  I am a CNM in Anchorage AK.  I have been to many of your presentations mostly at Contraceptive Technology conferences.  I hope you can answer an IUD question for me. 

 

I have a long time client, now 28, white female, G0 (gravida:0).  She had a ParaGard IUD inserted by me about 6 months ago and was happy with it until recently.  She has had a few medical issues worked up over the years without definitive diagnoses. Recently she was worked up for possible Crohns without a definitive diagnosis.  Her latest complaints include her legs becoming purple, swollen and very painful; that resolved in the last few weeks, but moved into very easy bruising in her legs.  Her doctors are stumped and are “blaming” the IUD.  She had an MRI about a week ago and states that she could really feel her IUD vibrating, and now intercourse is painful.  I told her I was extremely skeptical that the IUD was causing a problem, but thought I should ask the expert! – especially if there is any question that she has some odd autoimmune issue. 

 

Thanks for any thoughts or insight you might have!

 

Cynthia Bonney, CNM


Good morning, Cynthia Bonney.

Your patient had a ParaGard inserted 6 months ago.

 

Easy bruising is very unlikely to be related to her IUD.  I have never heard of such an association.

 

What does concern me is the pain she is experiencing at the time of intercourse now.  Could she have a pelvic infection? 

 

I take it that the strings of her IUD are not further down suggesting a possible partial expulsion.

 

What are you thinking is the causes of the pain at the time of intercourse?  What else do you want me to know about her history?

 

Her email reply on 1-3: “Dr. Hatcher thanks for your reply.  I called the patient back and she says she isn’t really having pain with intercourse anymore.  I had of course, checked for any kind of vaginal or pelvic infection.  She always seems to have some medical complaint that is receiving a huge workup.  Just wanted to be sure you couldn’t think of anything regarding the IUD.”

 

“Thanks so much!

 

Thanks for your follow-up.  Glad the pain with intercourse has stopped.

 

To learn more about the advantages and disadvantages of the ParaGard IUD, go to our website: www.managingcontraception.com and click on Choices.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?  

                                            

Key Words:  Contraceptive Technology, ParaGard IUD, medical issues, diagnoses, Crohns Disease, purple legs, swollen, painful, bruising, stumped, blaming, MRI, vibrating, painful intercourse, pelvic infection, strings, possible partial expulsion

Posted 1-5-2011, Updated 1-5-2011

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2011-01-6


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The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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