What causes a rash after intrauterine (IUD) insertion?

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Last updated: March 19, 2025View editorial policy

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From the Guidelines

You should contact your healthcare provider immediately if you experience a rash after an intrauterine device (IUD) insertion, as it could be a sign of an allergic reaction, infection, or other complication 1. The rash could be due to several causes including an allergic reaction to the IUD material, a localized skin irritation from the insertion procedure, or an unrelated skin condition. Some possible causes of the rash include:

  • Allergic reaction to the IUD material, such as copper or hormones
  • Localized skin irritation from the insertion procedure
  • Unrelated skin condition, such as eczema or dermatitis For mild symptoms, you might try applying a cool compress to the affected area and taking an over-the-counter antihistamine like cetirizine (Zyrtec) 10mg or diphenhydramine (Benadryl) 25-50mg for temporary relief 1. However, if the rash is accompanied by fever, severe pain, unusual discharge, or is spreading rapidly, seek immediate medical attention as these could indicate an infection or severe allergic reaction. It's also important to note that some people may develop sensitivity to metals like copper in certain IUDs, while hormonal IUDs might cause skin reactions in others due to the released hormones affecting your body's response. Your healthcare provider might need to remove the IUD if the reaction is severe or persistent, and they will be able to provide further guidance and treatment options.

From the Research

Possible Causes of Rash after IUD Insertion

  • Infection: The insertion of an IUD can be associated with a small increased risk of pelvic inflammatory disease and ascending infection, particularly in patients with risk factors 2.
  • Allergic Reaction: Although not directly mentioned in the studies, an allergic reaction to the materials used in the IUD or to the procedure itself could potentially cause a rash.
  • Candidal Vulvovaginitis: IUD use can be associated with vaginal candidiasis, with a higher prevalence of Candida species in cervicovaginal smears after IUD placement, especially with copper IUDs 3.

Complications of IUD Insertion

  • Uterine perforation: A serious complication of IUD use that can occur during insertion, leading to displacement of the device into the abdominopelvic cavity 4.
  • Expulsion: May occur with both types of IUDs, copper-releasing and progestin-releasing 5.
  • Streptococcal Toxic Shock Syndrome: A rare but potentially catastrophic complication after IUD insertion, especially in patients presenting with fever and sepsis soon after the procedure 2.

Post-Insertion Symptoms

  • Menstrual blood loss and dysmenorrhea: Increased in some women, especially with copper-releasing IUDs 5.
  • Spotting and bleeding: Increased during the first months after insertion, especially with progestin-releasing IUDs 5.
  • Cramping: May occur after IUD insertion, and can be a reason for device removal 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Streptococcal Toxic Shock Syndrome After Insertion of a Levonorgestrel Intrauterine Device.

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2019

Research

Comparison of copper IUDs and hormonal IUDs in prevalence of Candida species in cervicovaginal smears.

Cellular and molecular biology (Noisy-le-Grand, France), 2022

Research

Dislocated intrauterine devices: clinical presentations, diagnosis and management.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2021

Research

Insertion and removal of intrauterine devices.

American family physician, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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