Can uterine artery Doppler parameters predict copper intrauterine device-induced side effects?

Abstract

OBJECTIVES To evaluate the predictive value of uterine artery Doppler characteristics in predicting copper intrauterine device (IUD)-induced side effects such as dysmenorrhoea and menorrhagia, and worsening of dyspareunia. METHODS One hundred and twenty regularly menstruating women were enrolled in the study. All underwent transvaginal uterine artery Doppler analysis in the early follicular phase, on two occasions: before insertion of the IUD, and six months after insertion. Pre- and post-insertion resistance (RI) and pulsatility (PI) indices of the uterine arteries were measured. Doppler parameters were compared between subjects experiencing an increase in IUD-mediated side effects and those reporting no change. RESULTs RI and PI of all participants before and after IUD insertion were not significantly different (0.75 ± 0.06 vs. 0.74 ± 0.09, p = 0.49; 1.81 ± 0.55 vs. 1.83 ± 0.70, p = 0.7, respectively). No significant difference was found in the comparison of pre- and post-insertion PI and RI values of women who had increased- and those who experienced no change in dysmenorrhoea, dyspareunia and duration/amount of menstruation. CONCLUSIONS No major changes in uterine blood flow were observed in women experiencing increased menstrual bleeding, dyspareunia or dysmenorrhoea after insertion of a copper IUD. The occurrence of these effects cannot be predicted by prior Doppler flow analysis.

Doppler ultrasound for prediction of IUCD-induced heavy menstrual bleeding: a prospective cohort study

“…Indeed, there is some controversy regarding uterine artery PI and RI in IUCD users. Some studies suggest no difference in RI and PI before and after insertion [10][11][12][13], and others demonstrate a PI increase in the midluteal phase, yet still agreed with this study and suggested decreased uterine artery PI after IUCD insertion [14]. Some studies reported no statistical difference between women with IUCD-induced heavy menstrual bleeding and those using IUCD with normal menstruation [15,16].…”

The effect of copper intrauterine device use duration on uterine and ovarian blood flow parameters: A prospective cross‐sectional study

“…They found no significant difference concerning uterine artery RI and PI values before and after IUD insertion. Mutlu et al 17 compared the uterine artery PI and RI values of 104 women before copper IUD insertion and 6 months later. They observed no significant change in uterine artery PI and RI values.…”

“…In contrast to these findings, Yigit et al 18 reported higher uterine artery PI and S/D values 3 to 5 months after the insertion of copper IUD than before insertion. All the above‐mentioned studies 11,16‐18 compared the results of patients using IUD for less than a year. In accordance with the aforementioned studies, 11,16‐18 we observed that uterine artery Doppler variables in women having used IUDs for less than 1 year were similar to those who did not use an IUD.…”

Effect of core muscles strengthening exercises on pelvic pain caused by copper intrauterine device

“…Pelvic pain was the most frequently IUD associated complication; it was defined as having significant pain and cramping during and / or prior to menstrual cycle that were not present before IUD was inserted (6). This cramping (menstrual pain) is thought to be due to the presence of increased abnormal uterine contractility and decreased uterine blood flow (7). It was found that according to the analysis of Demographic and Health Survey (DHS) data 38% of women had chosen to discontinue the use of IUD due to its complication as bleeding and pelvic pain (8).…”

“…Copper IUDs were recorded to increase the release of prostaglandin and even to cause pain. This pain is one of the cited reasons for cessation of intrauterine contraception or a reason for not using the IUD (3), (7) & (9). Even though these side effects, the cumulative continuation rates for IUDs up to three years have been reported to be among the highest of all modern methods of contraception (10) & (11).…”