A 30-year-old woman undergoes insertion of a copper intrauterine device. She asks about her risk of developing pelvic inflammatory disease related to the device. The risk of PID following IUD insertion is highest during which time period?

• A Between 3 and 6 months after insertion
• B Between 1 and 3 months after insertion
• C First 20 days after insertion ✓
• D The risk remains uniformly elevated throughout the life of the device

Explanation

The excess risk of PID with an IUD is concentrated in the first 20 days after insertion, reflecting contamination of the uterine cavity at the time of placement, often with pre-existing cervical pathogens such as Chlamydia trachomatis or Neisseria gonorrhoeae. After this window the risk falls to near baseline. This is why screening for sexually transmitted infections before insertion matters more than long-term antibiotic prophylaxis.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.