342. Experience with the use of active and inert intra-uterine devices and their action on uterus, endometrium and vaginal cytology

Abstract

3 groups (10 patients each) were included in the study. The action of either an inert of active IUD was investigated in each group (5 cases for each device). Group 1 consisted of patients with premenopausal abnormal menstrual bleeding who were observed through 3 cycles after inserting IUDs. Group 2 consisted of patients with normal menstrual function but who had been admitted for hysterectomy. They were observed for 1 cycle after fitting IUDs following which a histological study of the surgical specimen was performed. Group 3 consisted of normal young women observed through 2 cycles after insertion of IUDs. The active T IUD releasing 70 mcg of progesterone a day or an inert IUD were inserted and gynecological evaluation was made before and after the insertion checking both clinical characteristics of menstruation and hormonal evaluation by means of cytology and endometrial biopsy. In Group 3 menstrual bleeding decreased significantly both in amount and duration as well as the frequency of menstruation. 2 cases developed amenorrhea. In both Groups 1 and 2 uterine activity was increased in response to the active IUD with respect to the response observed with the inert IUD particularly in the intensity of contractions during the 2nd phase of the menstrual cycle. However the frequency of contractions decreased. It is concluded that progesterone given in such a way has a definite local action on the uterus and specially on the endometrium without colateral systemic action. It is therefore useful in the management of dysfunctional uterine bleedings. (FULL TEXT)