IUD Complications

An intrauterine device (IUD) is a contraceptive method installed in the female uterine cavity. It is also called an IUD. There are many types of IUDs. Generally, metal or mixed rings are more common, or plastic and silicone materials. After a woman has an IUD installed, it is easy to cause complications in the body, inflammation, irregular menstruation, etc., and it is also easy to cause a decrease in menstrual flow.

What are the complications of an IUD?

1. Abnormal menstruation

The average menstrual blood volume for women is 31-39ml, and for Chinese women it is 47-59ml. Abnormal menstruation is defined as excessive menstrual blood volume exceeding 80ml, prolonged menstrual period exceeding 7 days, spotting if the amount of extramenstrual bleeding is small, and irregular bleeding if the amount of extramenstrual bleeding is large.

The placement of a copper-containing intrauterine device usually leads to menstrual abnormalities with heavy menstrual flow, prolonged menstrual period, and spotting, with no cyclical changes. The placement of a copper-containing intrauterine device can increase menstrual blood volume by 40-50% within 6-12 months, and usually improves after 2 years. Prolonged menstruation or spotting can also last for more than a year; users can usually tolerate it for about half a year. Insertion of an intrauterine device containing a progestin, such as Mirena, can reduce menstrual flow, but irregular periods and amenorrhea are common.

The cause of abnormal menstrual bleeding is not a single factor. The main reason is that the IUD changes the coagulation mechanism inside the uterine cavity:

1. The endometrium is necrotic due to mechanical friction or compression, causing ulcers on the surface epithelium and bleeding; the vascular permeability in the non-ulcer area increases; the spiral arterioles in the endometrial spongy layer dilate, the vascular wall degenerates and defects, the vascular endothelium is damaged, and red blood cells overflow from the vascular defects;

2. Increased levels of plasminogen activators and enhanced fibrinolytic activity lead to abnormal intimal hemostasis.

3. Intrauterine contraceptive devices cause aseptic inflammation or foreign body reaction of the endometrium, which may increase the production of prostaglandins, causing vasodilation and platelet inhibition; mast cells in the endometrium in contact with the IUD can release vasodilator substances - histamine and anticoagulant substances - heparin; factor VIII is generally reduced;

4. Other reasons.

To prevent abnormal menstruation caused by intrauterine devices, first choose the intrauterine device correctly. Choose a suitable IUD based on the size and shape of the uterine cavity. For those with heavy menstruation, you can choose an IUD containing indomethacin. Strictly grasp the indications and contraindications. At the same time, it is important to master the placement technique; provide good preoperative consultation, explain the possible adverse reactions of the IUD, and increase tolerance.

The principles for the treatment of menstrual abnormalities caused by intrauterine devices include: first, inform women that heavy menstrual flow or prolonged menstruation within 3-6 months of IUD insertion is generally harmless and will be alleviated with prolonged use.

If the menstrual flow is heavy and lasts for a long time, it may cause anemia. On the premise of excluding gynecological diseases, hemostatic and anti-inflammatory drugs can be given. For women who continue to bleed, have symptoms of anemia, or have difficulty accepting it, the IUD should be removed and they should be helped to choose other contraceptive methods. Anemia can be prevented by providing blood tonics and encouraging foods that are iron-rich.

pain

Pathological pain is caused by injury and secondary infection. Physiological pain is not caused by complications of the intrauterine device and disappears after removal.

The stages of pain include early pain, delayed pain, and late pain. If the pain occurs within 10 days after the IUD is inserted, it is mostly physiological and is called early pain. If the pain persists for more than 10 days, it is mostly delayed pain due to the poor fit between the IUD and the uterine cavity. Late pain occurs more than one month after the device is placed and is mostly pathological, requiring the exclusion of infection, IUD incarceration, and downward migration.