An intrauterine device, or IUD, is considered to be a very effective and safe contraceptive method, yet there are risk factors. What happened to a 54-year-old woman in Japan who left the device in her body far beyond what’s permitted? It should serve as a warning to other women.
Even today, 60 years after birth control pills were first marketed, women are the ones who must be responsible for contraception. This burden can be dangerous. One such risk came true for a woman whose IUD was left in her body for 20 years, leading to a serious infection called actinomycosis.
When this woman started to suffer from abdominal pain and fever, doctors found a very old IUD, infected and surrounded by abscesses that were triggered by bacteria called Actinomyces israelii.
Fortunately, the infection can be treated with antibiotics but the case study, published in The New England Journal of Medicine, emphasizes the importance of replacing an IUD before the expiration date.
IUDs are the most effective contraceptives, with a success rate of 99%-99.8% in preventing conception, depending on the type of device. This is a particularly high figure compared to data that show that hormone pills are 91% effective.
These rates take into account risks of experiencing forgetfulness, effects of various medications, vomiting, diarrhea and more. The devices are divided into two types: a hormonal IUD that secretes progesterone, and a non-hormonal device. Remember, although they prevent conception in most cases, these devices come with certain risks.
The woman in this case was 54 years old and suffered from weight loss, pain, fever and difficulty walking for several months before she went to the emergency room. A physical exam found a lump in the lower left quadrant of her abdomen that was soft to the touch, so doctors ordered a CT scan. The findings showed a collection of abscesses around the device, which was still in the uterus. Blood test results showed a massive infection as the number of white blood cells trying to fight the infection, which was rapidly increasing, had spread beyond the pelvis and into the left hip.
Actinomyces israelii bacteria are also found in the vagina of healthy women, but under certain conditions they can create an active infection known as actinomycosis. The bacteria are characterized by sulfur-colored granular rods and although this condition might be dangerous and chronic, it can be treated with the help of massive antibiotic treatment.
After all the tests confirmed that these were bacteria, the woman received extensive intravenous antibiotic treatment and was reported to have recovered with no lasting complications.
Her IUD was made of plastic, and should have been removed after five years, meaning it was in her body for 15 years beyond what was permitted.
Also, besides infections such as actinomycosis, expired devices are ineffective at preventing contraception.