Vascular defects in human endometrium caused by intrauterine contraceptive devices

Hohman, W.R.; Shaw, S.T.; Macaulay, L.K.; Moyer, Dean L.

doi:10.1016/0010-7824(77)90074-9

Cited by 27 publications

(9 citation statements)

References 25 publications

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“…This damage included micro-vascular endothelial degeneration, necrosis, and defect formation between and within endothelial cells and in adjacent basement membranes [14,15]. The investigators postulated that the damage was caused by mechanical pressure forces transmitted through the endometrium, resulting from myometrial contractions around the rigid IUD in the uterine cavity.…”

Section: Discussionmentioning

confidence: 99%

The morphologic changes of endometrial spiral arterioles in IUD-induced menorrhagia

Pan

Wang

et al. 1994

Adv Contracept

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To investigate the relationship between IUD-induced menorrhagia and spiral arteriolar function, we examined the endometrium under light and electron microscope on samples obtained within 24 hours after the onset of premenstrual spotting. These samples included an IUD bleeding group (20 cases), an IUD non-bleeding group (20 cases) and an IUD non-user group (10 cases) as controls. Compared with the IUD non-user group the degenerative changes of spiral arteriolar wall were more severe and dilation of the spiral arteriolar lumen was more obvious, especially in the spongeous layer. In the IUD non-user group these changes were mild, suggesting that IUD-induced menorrhagia might be correlated with poor contractility of spiral arterioles in the spongeous layer.

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Section: Discussionmentioning

confidence: 99%

The morphologic changes of endometrial spiral arterioles in IUD-induced menorrhagia

Pan

Wang

et al. 1994

Adv Contracept

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“…ALL intrauterine contraceptive devices (IUCDs) 1967; Hohman et a/, 1977 andShaw et al, with the exception of progestogen releasing 1979; Sheppard and Bonnar, 1980) or during late IUCIIs increase the amount of menstrual blood menstruation (Aparicio et al, 1979). Current loss and most of them increase the duration of knowledge on the pathogenesis of IUCDmenstruation (Guillebaud et a/, 1976;Guille-induced abnormal bleeding patterns have been baud and Edelman, excellently reviewed by Moyer (1980).…”

Section: Discussionmentioning

confidence: 99%

Haemostasis in Menstrual Endometrium in the Presence of an Intrauterine Device

Christiaens

Sixma

Haspels

1981

BJOG

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The histology and ultrastructure of the haemostatic response in the endometrium have been studied in 12 uteri containing an inert or copper wound intrauterine contraceptive device ( I UCD). The uteri were removed during the premenstrual phase or during the first 96 hours of menstruation. The results have been compared to earlier observations in non-IUCD influenced endometrium. In all uteri the tissue shedding proceeded more slowly in the presence of an IUCD andconsiderablyfewer haemostatic plugs were found. The platelets in these plugs were more loosely packed and less degranulated, and the plugs contained less fibrin than in the absence of an IUCD. Haemostatic plugs were still observed at times when no such plugs were seen in uteri without an IUCD. Unoccluded vessel lesions were regularly seen and vessels open to the shedding surface were occasionally encountered. These observations suggest that I UCD-induced menorrhagia is caused by the combination of delayed shedding and a decreased haemostatic reaction in the endometrium.

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“…The irritating effects of the IUD itself and possibly the release of copper ions into the endometrium have been held responsible for the menorrhagic effect. Direct mechanical damage to the endometrium can lead to ulceration and erosion, but these lesions are not usually sufficiently numerous to explain the excessive amount of bleeding during menstrual periods [1][2][3]. No correlation was found between the histological findings and excessive hemorrhage with or without the IUD [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…The extravasation of red blood cells and plasma through the qesions' of the endometrium offers a morphologically based explanation for the etiology of intermenstrual spotting [1,6]. The occurrence of interstitial edema with extravasation of red blood cells in the endometrium with presence of an IUD and the almost complete absence of local blood coagulation [3,5] combined with increased vascular permeability and capillary fragility, have led to attempts to increase capillary resistance, for instance by treatment with vitamin C and iron [7].…”

Section: Introductionmentioning

confidence: 99%