Who should NOT use a hormonal IUS?

If women experience certain complaints or underlying diseases, the IUS may not be the best choice for contraception. However, the decision must be based on a number of factors. When the following questions are answered, a decision on the best contraceptive method is possible:

  • What is the expected risk of an IUS compared to another effective method?
  • How great is the risk of becoming pregnant?
  • What health effects would a possible pregnancy have?

If one or more of the following conditions apply, an IUS may be inadvisable:

  • Existing or suspected pregnancy
  • Changes in the shape of the uterine cavity, e.g., myomas, septum, or divided uterus
  • Acute infection in the inner genital area
  • Cell changes in the cervix
  • Malignant diseases of the uterus
  • Breast cancer
  • Acute liver disease
  • Hypersensitivity to levonorgestrel or any of the other components of the hormone IUS
  • Acne or blemished skin

According to the manufacturer, the IUS should also not be used by women who suffer from migraine or severe vascular disease. However, the specialist literature has other recommendations for migraine. For example, a recognized recommendation from England (NICE) writes: “Methods that only contain progesterone, such as the hormonal IUS, can be used by women who suffer from migraine with or without aura”. In addition, women whose migraine is triggered by menstruation can assume that seizures under a hormonal IUS will be less frequent.