# cytotek before IUD?



## kodis'mom (Nov 29, 2006)

I called my CNP to schedule an IUD istall in about two weeks, and was told that they would be prescribing me cytotek to soften my cervix. I am aware that cytotek is not inteded for use in this manner. I am curious if EPO would work, or if anyone else here has used cytotek to soften their cervix while not pregnant?


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## meggles (Mar 9, 2004)

That's wacky. I wouldn't use cytotec for anything, ever. It has not been approved for gynecological use...I believe it is an anti-ulcer medication or something of that sort.


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## kodis'mom (Nov 29, 2006)

yeah, thats why I'd like to know if there is something else I could use to get a nice soft cervix...no way am I putting that stuff in my body, unless I have a peptic ulcer!


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## AugustineM (Mar 21, 2005)

You might want to post this in the family planning forum. There is a lot of IUD info there.

I had an IUD inserted at about 10 wks PP and they just used the cervical dilator a tiny bit and inserted it. I barely felt it.

You might want to read around on the IUD website (paragard, Mirena, depending on which one you're getting) and see what the normal insertion procedure is. I've never heard of applying cytotec... weird.


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## Baby Hopes (Jul 15, 2004)

Read up on Cytotec. Read and then RUN as fast as you can. Cytotec is dangerous and absolutely NOT approved for labor induction or cervix softening. Unlike other induction options there is no way to "un-due" cytotec.

Okay, I just re-read your post and saw that you are *not* pregnant (right) and you are wanting to take the drug in order to get an IUD? (See, I see the word "cytotec" and I get all freaked out. LOL.)

I don't have any experience with IUD's and cannot tell you what is standard proceedure for IUD cervix softening. EPO capsules inserted onto your cervix would probably help without some of the potentially hazardous side effects. (What can I say, I have serious reservations about the use of cytotec in ANY manner asides from the manner in which it's approved = Ulcers.)


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## JBaxter (May 1, 2005)

I know 5 close friends who have had IUDs ( including my sister) and NONE have used that. I would ask a big WHY.


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## MsElle07 (Jul 14, 2006)

I know a number of people with IUDs placed in the past two years (at least five), and NONE have had cytotec. There are some practitioners who request that you make an appt during your period, because your cervix is softer and more open then, but if you've given birth vaginally, even that is not necessary. Say no to cytotec!


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## AKmoose (Jul 25, 2003)

I've never heard of using any type of "softener" prior to IUD insertion. When mine was put in, I was about 8 wks post-partum, and it was really no big deal...I think if you're not post-partum, they want to schedule you at the end of your period (during maybe?) so the cervix is slightly opened/softened naturally. I think most practitioners will only do IUDs on women who've had kids just for this reason...rambling on here...my point is - I agree with the pp - RUN away from cytotek!!


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## texaspeach (Jun 19, 2005)

I've never had children, but when discussing IUD insertion with my doc she never mentioned cytotec, just said I'd have to come in during my period


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## touka (Oct 5, 2006)

I was given a mild local anesthetic, nothing more.

Quote:


Originally Posted by *AKmoose* 
...I think if you're not post-partum, they want to schedule you at the end of your period (during maybe?) so the cervix is slightly opened/softened naturally.

Yes, this is accurate.

Quote:

I think most practitioners will only do IUDs on women who've had kids just for this reason...
Nope. While there are still some med folks who won't do it, most will given it's effectiveness and the low risk of known possible (but quite rare) complications.


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## maxmama (May 5, 2006)

Cytotec (aka misoprostol) is not the devil. It's a prostaglandin. It works very well for cervical ripening and postpartum hemorrhage, and while I wouldn't use it for my own cervical ripening (being post-section) pregnant, I took it for pp bleeding.

That said, I've never used miso before my IUD insert, and while I have been pregnant I've never labored. None were especially painful,and for the last one I didn't even need a cervical dilator.

As far as the "not approved for gynecological use" argument goes -- please. Neither domperidone nor metoclopramide are approved for lactation either, and I hardly think anyone whose argument against miso is its lack of approval for labor would be jumping all over anyone for using them. It's off-label use. It doesn't mean it's bad medicine.


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## ktbug (Jul 8, 2006)

You can't deny that cytotec has a dark history of misuse in OB circles, though ... it has a bad name for a reason. Approved for gyno use or not, it's caused some problems, to be sure.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *ktbug* 
You can't deny that cytotec has a dark history of misuse in OB circles, though ... it has a bad name for a reason. Approved for gyno use or not, it's caused some problems, to be sure.

What medication hasn't?


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## Sagesgirl (Nov 22, 2001)

Quote:

It's off-label use. It doesn't mean it's bad medicine.
It is not merely off-label use, it is _off-label use both the drug's manufacturer and the FDA warn against_.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *Sagesgirl* 
It is not merely off-label use, it is _off-label use both the drug's manufacturer and the FDA warn against_.

Again, so is domperidone. There's a lot of CYA in drug marketing and approval that's based more in fear of lawsuits than evidence-based practice.


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## lolar2 (Nov 8, 2005)

Quote:


Originally Posted by *Sagesgirl* 
It is not merely off-label use, it is _off-label use both the drug's manufacturer and the FDA warn against_.

The drug's manufacturer and the FDA warn against its use in pregnant women, so that applies to OB use. They don't say anything one way or another about GYN use in women who are not pregnant.


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## WinterBaby (Oct 24, 2002)

I can't see that the cytotec carries any great risk in this application. I'd also take a motrin, or a couple ibuprofen about half an hour before insertaion for the cramping though.

As for the other stuff - IUDs are only reccommended for women who've perviously had children by the manufacturer purely out of lawsuit concerns over sterility in women who've never had children. And I don't think it really matters at what point in your cycle they insert it, but inserting during your period is at least extra insurance that you aren't currently pregnant.


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## Herausgeber (Apr 29, 2006)

My OB wants me to wait until my cycle returns to insert mine. If I really wanted to get it sooner, he said he could use misoprostol (Cytotec) to soften my cervix, but he'd rather not.


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## applejuice (Oct 8, 2002)

I thought there was a seaweed type of tampon (laminara)? that is used to dialate the cervix for D/Cs and other gynecological procedures???


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## BeckiCNM (Jun 21, 2006)

Quote:


Originally Posted by *WinterBaby* 

As for the other stuff - IUDs are only reccommended for women who've perviously had children by the manufacturer purely out of lawsuit concerns over sterility in women who've never had children. And I don't think it really matters at what point in your cycle they insert it, but inserting during your period is at least extra insurance that you aren't currently pregnant.

The ParaGard IUD (the non-hormonal one) has been approved by the FDA for use in women who have not had children - I think they changed the labeling to allow that use about a year and a half ago.

And I have heard of people using misoprostol before an IUD insertion, but I haven't done it myself.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *applejuice* 
I thought there was a seaweed type of tampon (laminara)? that is used to dialate the cervix for D/Cs and other gynecological procedures???


Lams carry a risk of infection that frankly I wouldn't bother with just for an IUD insertion.

And really, IUDs don't require much (if any) dilation.


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## maxsmum (Nov 29, 2006)

Quote:


Originally Posted by *BeckiCNM* 
The ParaGard IUD (the non-hormonal one) has been approved by the FDA for use in women who have not had children - I think they changed the labeling to allow that use about a year and a half ago.

And I have heard of people using misoprostol before an IUD insertion, but I haven't done it myself.

I had a paraguard inserted 7 years ago before having any children and again 6 months ago after pregnancy. I took ibuprofin both times before the visit that is it. The first time it killed (probably because it had never been opened before), the second time - no problem.


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## pamamidwife (May 7, 2003)

Cytotec, or misoprostal, will not cause issues when used in this manner, or for postpartum hemorrhage.

However, I will say that you should avoid intercourse at all costs (or be on the pill) for at least three weeks prior to the insertion. I've known too many women that have been pregnant (without the fertilized ovum implanted yet) when they had their IUD inserted. All lost their babies, one with an ectopic pregnancy and the other without knowing she was preg at 5 months along.

Still, you don't need much opening of the cervix to insert the applicator for the IUD. Doing it at the end of your menstrual period would be smart.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *pamamidwife* 
Cytotec, or misoprostal, will not cause issues when used in this manner, or for postpartum hemorrhage.

However, I will say that you should avoid intercourse at all costs (or be on the pill) for at least three weeks prior to the insertion. I've known too many women that have been pregnant (without the fertilized ovum implanted yet) when they had their IUD inserted. All lost their babies, one with an ectopic pregnancy and the other without knowing she was preg at 5 months along.

Right, it's why you can use an IUD as EC for five days post IC.


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## kodis'mom (Nov 29, 2006)

Than you for all of your replies! I think the reason they want to use miso. is because I have never had a child, I guess I need more help getting the cervix open. I have done quite a bit of research, and don't feel that I would be at any risk as I am most certainly not pregnant at this time, and it might even help my acid reflux! I guess I just wonder if EPO would work to soften my cervix even though I'm not pregnant.


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## pamamidwife (May 7, 2003)

I would say no for the EPO - you can take it all throughout pregnancy and it's not going to just soften your cervix. I don't feel that EPO really softens the cervix, but it may help your own body's ability to soften the cervix....but that's at the end of pregnancy, when our body naturally would do that. Not necessarily when you're not pregnant.

Many women get IUDs at the end of their bleeding - even those that have never had babies before. The misoprostal might help, though, overall.


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