Intrauterine device menorrhagia

Harrison RF, Cambell S. A double-blind trial of ethamsylate in the treatment of primary and intrauterine-device menorrhagia. Lancet 1976 2(7980) 283-5. 

Kovacs L, Annus J. Effectiveness of etamsylate in intrauterine-device menorrhagia. Gynecol Invest 1978 9(4) 161-5. 

Menorrhagia also may be treated with the levonorgestrel-releasing intrauterine device (IUD). This is a very effective treatment that consistently reduces menstrual flow by 90% or greater.29,30 Its use has resulted in the postponement or cancellation of scheduled endometrial resection surgery or hysterectomy. Specifically, 60% of treated patients have been able to avoid hysterectomy.30,34,35... 

Levonorgestrel is used in the form of intrauterine devices, both as a contraceptive and to treat menorrhagia. They are effective, but critical reviewers continue to point to the need to be alert to the possible development of pain and hypermenorrhea, and to warn patients of the possibility of expulsion or perforation (46). 

Q4 Excessive bleeding during the menstrual period is called menorrhagia. The blood loss reduces levels of iron in the body and may result in iron-deficiency anaemia. The causes of excessive bleeding could be inflammation, fibroids, endometriosis, cervical polyps, adenomyosis, ovarian tumours, intrauterine devices (IUDs), inherited clotting disorders, endocrine dysfunction, such as thyroid dysfunction, or mental stress. In terms of drug therapy, oral ferrous... 

Fedele L, Bianchi S, Raffaelli R, Portuese A, Dorta M (1997) Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device. Fertil Steril 68 426-429... 

Mercorio F, De Simone R, Di Spiezio Sardo A, Cerrota G, Bifulco G, Vanacore F, Nappi C (2003) The effect of a levonorgestrel-releasing intrauterine device in the treatment of myoma-related menorrhagia. Contraception... 

There is a positive correlation between high copper loss from an intrauterine contraceptive device and the development of menorrhagia or pathological lesions, such as cervical dysplasia and endometrial cjdopathol-ogy (14). Evidence of endometrial carcinoma was not found in endometrial aspirates from 189 women who had used Copper-T-200 devices for 1-10 years, but five cases of endometrial hyperplasia (2.67%) were encountered in women in the series, all of whom had worn... 

A Copper-T intrauterine contraceptive device migrated to the rectal lumen in a 36-year-old woman with menorrhagia for 3 months and a history of Copper-T insertion 6 years before (16). 

A case report from Germany has underlined the clinical importance of early recognition of edetate-induced pseudo-thrombocjhopenia (SEDA-21, 250) (40). In this case, artefactual thrombocjhopenia led to a bone marrow puncture and treatment with high doses of glucocorticoids, with severe Cushing s sjmdrome as a result. In such patients, concomitant bleeding disorders (without true thrombocytopenia), for example menorrhagia due to an intrauterine contraceptive device, can add to the confusion. 

Etamsylate is more widely used to treat menorrhagia, including that associated with use of intrauterine contraceptive devices (10-12), although its efficacy has been challenged. A meta-analysis of drugs available in primary care showed that tranexamic acid was the most effective... 

Westrom L, Bengtsson LP. Effect of tranexamic acid (AMCA) in menorrhagia with intrauterine contraceptive devices. J Reprod Med 1970 5(4) 154-61. 

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