Levonorgestrel Releasing IUS (Metraplant E) in the Management of Copper IUD Related Heavy Painful Menstrual Loss | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 14, Volume 71, Issue 5, April 2018, Page 3158-3165 PDF (379.51 K) | ||||
| Document Type: Original Article | ||||
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| Author | ||||
| Mohamed Ezz El-Din Aly Azzam*, Amal El-Shabrawy EL-Sayed, Samah Mohamed Ali Abd El- Azym | ||||
| * Obstetrics and Gynecology Department, Ain Shams University. | ||||
| Abstract | ||||
| Background: the LNG-IUD was first introduced in Finland in 1990 and is currently marketed in most European countries and in the US since 2000. The Levonorgestrel IUD is approved for 5 years, but lasts up to 10 years and reduces the menstrual blood loss and pelvic infection rates. Aim of the Work: this study aimed to evaluate safety and efficacy of levonorgestrel releasing IUS (Metraplant-E) in the management of copper IUD related heavy painful menstrual loss. Among women of low socioeconomic status attended to family planning clinic at Abo-Elnomros Hospital (Abo-Elnomros is small village –Giza Government, Egypt. Patients and Methods: this was a prospective cohort study and it was performed in Abo- Elnomros hospital. Women who attended to the hospital (Family planning clinic) for IUD follow up and had complications (bleeding and dysmenohrea) for which copper IUD is removed. Results: all women in the present study reported a marked reduction in MBL, which started from the first menstrual period following insertion of Metraplant –E. Bleeding was reduced further over the next months until the 6th month except two cases . Amenorrhea occurred in 38 cases. The difference in menstrual bleeding was highly significant (P <0.0001). Hemoglobin level increased from a mean baseline value of 10.0 ± 1.3 at baseline controls to a mean level of 10.5 ± 1.2 after 6 months of Metraplant-E use. Differences in hemoglobin levels were highly significant P <0.0001. Conclusion and Recommendations: the copper IUD is the most commonly used method of reversible contraception worldwide and is used by an average of 23 percent of female contraceptive users. The copper IUD is associated with increased menstrual flow both in length of menses and in amount of blood loss. The most common reasons for the discontinuation of this method are menstrual bleeding and dysmenorrhea. Metraplant- E is effective in significantly reducing the amount of menstrual blood loss in women with heavy painful menstrual loss related to copper IUD. Strong endometrial suppression is the principal mechanism, explaining both the effect on menstrual blood loss and the contraceptive performance of the IUS. Proper treatment of the chronic endometritis prior to Metraplant-E insertion is recommended. Actively informing women about benefits, risks and common side effects of IUS appears to improve consideration and acceptance of the method. | ||||
| Keywords | ||||
| levonorgestrel releasing IUS; metraplant E; IUD; LARC | ||||
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