From the Research
Bleeding and Pain with IUD Use
- Bleeding and pain are common issues associated with Intrauterine Device (IUD) use, with studies indicating that they are among the major reasons for IUD removal 1, 2.
- The type of IUD and its design can contribute to these symptoms, with larger and stiffer devices potentially causing localized endometrial ulceration and inflammation, leading to bleeding and pain 2.
- Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be effective in reducing menstrual bleeding and pain associated with IUD use, and are recommended as first-line therapy for these symptoms 3.
Factors Influencing Bleeding and Pain
- The design of the IUD, including the shape and size of the device, can influence the likelihood of bleeding and pain 2.
- The use of atraumatic instruments, such as a vulsellum, during IUD insertion may reduce bleeding compared to traditional tenaculae 4.
- Pre-procedure anxiety has been correlated with increased pain during IUD insertion, suggesting that anxiolytic interventions may be beneficial in reducing pain 4.
- Embedment of the side arms of the levonorgestrel 52 mg intrauterine device in the myometrium has not been shown to be associated with unfavorable bleeding patterns or pelvic pain six weeks after insertion 5.
Management of Bleeding and Pain
- NSAIDs, such as naproxen, ibuprofen, and diclofenac, have been shown to be effective in reducing bleeding and pain associated with IUD use 3.
- Tranexamic acid may be considered as second-line therapy for bleeding associated with IUD use if NSAIDs are ineffective 3.
- Further research is needed to investigate the effectiveness of anxiolytic interventions in reducing pain during IUD insertion 4.