Article

Subendometrial microvascularization and uterine artery blood flow in IUD-induced side effects (levonorgestrel intrauterine system and copper intrauterine device).

Programa de Pós-graduação em Medicina: Ciências Médicas, Faculdade de Medicina, 90035-003 UFRGS, Brazil.
Contraception (impact factor: 2.72). 11/2008; 78(4):324-7. DOI:10.1016/j.contraception.2008.06.013 pp.324-7
Source: PubMed

ABSTRACT A better understanding of the uterine and endometrial vascularization in intrauterine device (IUD)-induced side effects is clearly of paramount importance in terms of both physiological and pathophysiological changes and may permit assessment for future therapeutic treatments. The aim of the study was to quantify the subendometrial microvascularization and uterine artery blood flow in IUD-induced side effects using power Doppler analysis as well as pulsatility index (PI) and resistance index (RI) in the exact midluteal phase 3 months after IUD insertion. There were 27 patients using the levonorgestrel-releasing intrauterine system and 25 patients using TCu 380A.
This study has a prospective clinical trial design.
There is an increased subendometrial blood flow in patients with severe dysmenorrhea and/or bleeding, after controlling for IUD type, age and parity. Moreover, the PI and RI were not different in such women.
The results provide new data on the bleeding patterns related to these IUD types that may be relevant during contraception use. This method could be used as a prognostic factor to better evaluate women for the risk of developing dysmenorrhea and/or bleeding after IUD insertion.

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    Article: Levonorgestrel-releasing IUD versus copper IUD in control of dysmenorrhea, satisfaction and quality of life in women using IUD
    Fatemeh Ramazanzadeh, Toktam Tavakolianfar, M Sc, Mamak Shariat, Seyed Javad, Purafzali Firuzabadi, Medical Student, Fedieh Hagholahi, B Sc
    [show abstract] [hide abstract]
    ABSTRACT: Background: The levonorgestrel-releasing IUD can help the treatment of dysmenorrhea by reducing the synthesis of endometrial prostaglandins as a conventional treatment. Objective: This study was performed to assess the frequency of dysmenorrhea, satisfaction and quality of life in women using Mirena IUDs as compared to those using copper IUDs. Materials and Methods: This double-blind randomized clinical trial was performed between 2006 and 2007 on 160 women aged between 20 to 35 years who attended Shahid Ayat Health Center of Tehran, and they were clients using IUDs for contraception. 80 individuals in group A received Mirena IUD and 80 individuals in group B received copper (380-A) IUD. Demographic data, assessment of dysmenorrhea, and follow-up 1, 3 and 6 months after IUD replacement were recorded in questionnaires designed for this purpose. To assess the quality of life, SF36 questionnaire was answered by the attending groups, and to assess satisfaction, a test with 3 questions was answered by clients. Results: Dysmenorrhea significantly was decreased in both groups six months after IUD insertion as compared to the first month (p<0.001). However, statistically, Mirena reduced dysmenorrhea faster and earlier compared to cupper IUD (p<0.003). There isn't any significant difference between these two groups in satisfaction and quality of life outcomes. Conclusion: There is no difference between these two groups in terms of the satisfaction and quality of life, therefor the usage of Mirena IUD is not a preferred contraception method.
    Iranian Journal of Reproductive Medicine 02/2012; 10:41-46. · 0.26 Impact Factor
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Keywords

bleeding patterns
 
contraception use
 
endometrial vascularization
 
future therapeutic treatments
 
increased subendometrial blood flow
 
intrauterine device
 
IUD insertion
 
IUD type
 
IUD types
 
IUD)-induced side effects
 
IUD-induced side effects
 
levonorgestrel-releasing intrauterine system
 
pathophysiological changes
 
power Doppler analysis
 
prognostic factor
 
prospective clinical trial design
 
pulsatility index
 
severe dysmenorrhea
 
subendometrial microvascularization
 
uterine artery blood flow
 

Mirela F Jiménez