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Birth Control/Copper IUD...infection?

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Hi,

I'm hoping you can help me decide whether or not I need to go to the hospital for this.

I'm 29, female, and last weekend (Saturday 30th August into 31st August) I had protected sex with a new partner. We had sex several times throughout the night from about 11pm to about 7am the next morning. We used condoms with no issues. However during the early hours of the morning, I had been on top of my partner and when he had finished we couldn't find the condom. We searched everywhere but to no avail; I realized to my horror that the condom must be inside me. I tried to get it out. My partner also tried to get it out but without any luck. When I got home later that morning I used normal saline (for topical use) to irrigate the vagina and it didn't help. So I went to an out of hours service at my local hospital and the Dr there got it out. She prescribed Emergency contraceptives for me but I decided to also have an IUD fitted. I was working a 13 hour shift the following Monday (1st September) so I went to a clinic Tuesday 2nd September to have the IUD fitted.

I'm 29 and have never had children. I was given paracetamol (acetaminophen) prior to the procedure and a local anaesthetic to the cervix.The procedure itself was extremely painful, however I just wanted it to be over so asked the Dr to continue no matter how much I screamed and went home as quickly as I could.

After the procedure I experienced some bleeding and dull abdominal pain. The following next two days (3rd and 4th September) I did not notice any pain (only mild discomfort); however I'm not sure if I was in pain but didn't notice it. I work 13 hour shifts as an RN and I had very acutely unwell patients; I was extremely busy dealing with medical emergencies and although I felt discomfort in my abdomen I feel there may have been pain but I was too busy and engrossed in the emergencies to notice it.

Friday the 5th September is my day off, I'm at home and in mild to moderate pain. The pain is in my lower abdomen. It increases on movement and touch. My abdomen feels sore. I have the sensation that I can feel something in my uterus that is not supposed to be there. I have very mild nausea but no sickness as yet. I am apyrexial. My heart rate is 70 bpm at rest. I feel highly anxious.

My question is...is it normal to experience cramp like pains on day three post insertion? I am worried I may have developed PID. I also have lower back pain.

The pain isn't severe. Is it safe for me to wait until I have a day off next week and get bloods and an examination? Or should I go to the hospital tommorrow?

Lastly, I have metronidazole 200mg tablets around....should I take them?

Thank you very much for your help I look forward to your reply

Answer
It's normal to feel some cramping, but not severe.  It can be difficult to know whether you're having the normal cramps of an IUD insertion or there is an infection going on.  I would go by how you're feeling in general and whether the cramping seems to be getting better or worse.  If you run a fever or are feeling worse, then it's better to be seen.  Sometimes it will also be difficult for your doctor to know, but if there is much tenderness of the uterus on exam, usually the best thing is to take the IUD out.  We usually also give antibiotics, but usually the most important thing is getting the IUD out.

I wouldn't take the metronidazole.  I think that will only confuse the issue and make it harder to know what's going on.  A partially treated infection can be worse than a fully treated one.

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Norman Solberg

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I am an OB-GYN physician. I can answer almost any question related to women's health.

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35 years in an active OB-GYN practice.

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