Disturbances of bleeding with intrauterine contraceptive devices and hormonal intrauterine systems

Abstract

Abstract Menstrual bleeding disturbance is often reported as a side-effect in users of intrauterine devices (IUDs) for contraception and it is the most common reason for discontinuation of IUD use. Around 40-50 per cent of all terminations in IUD users occur as a consequence of perceived bleeding problems (Table 30.1). Termination rates for bleeding problems vary between studies and between centres, probably, in part, reflecting variations in attitudes and counselling among service providers (Table 30.2). The rates are similar for inert and copper IUDs and hormone releasing systems but the nature of the bleeding problems reported by the women is very different in users of inert or copper IUDs as compared with that in users of hormonal intrauterine contraception. The most common complaints with copper IUDs are increased menstrual blood loss, prolonged menstrual bleeding periods, and intermenstrual bleeding. The most common complaints with hormone-releasing intrauterine systems are intermenstrual bleeding, irregular bleeding, and amenorrhoea.