Patient's question:
My sister had a cesarean birth one year and nine months ago. She got an IUD implanted before May. After the implantation, her menstruation increased for the first two months, and then decreased by three months compared to before the implantation. Her menstrual cycle is 30 days. Is it normal?Doctor's answer:
Hello:Side Effects of IUDs:
1. Bleeding
Currently, it is believed that increased fibrinolytic activity caused by the IUD is the main reason for bleeding. Antifibrinolytic agents like 6-aminocaproic acid can reduce bleeding. Mild, irregular vaginal bleeding often does not require treatment; however, if the bleeding is heavy, medication to stop bleeding may be administered. If the bleeding does not subside after treatment, the IUD can be removed. In cases of prolonged bleeding, anti-infection treatment may be necessary.
2. Lower Back Pain and Abdominal Discomfort
This may be caused by an IUD that is too large or positioned too low, leading to uterine contractions. First, try using antispasmodic medication. If this is ineffective, consider replacing the IUD.
3. Infection
In some cases, infections can occur due to poor disinfection or non-sterile procedures, leading to ascending infections. If an infection develops, the IUD should first be removed, followed by appropriate treatment.
4. IUD Implantation
In rare cases, the IUD may become embedded in the uterine wall. If the embedding is shallow, it can still be removed using an IUD removal hook. If the embedding is deep, the cervix must first be dilated to sizes 6–7, then the IUD string should be brought to the cervix. The string should be straightened with two hemostats and cut before being removed. The procedure should be performed slowly and gently. If necessary, ultrasound guidance can be used to reduce the of the operation. If the IUD is very deeply embedded, even protruding through the uterine wall into the pelvic cavity, surgical removal (laparoscopy or laparotomy) may be required.
5. IUD Displacement
This often occurs within the first year of insertion, especially during the first three months of menstruation. Natural IUD displacement may be related to factors such as an IUD that is too large or too small, improper placement at the bottom of the uterine cavity, poor-quality material, insufficient support, a loose cervix, excessive physical exertion, or heavy menstrual bleeding. Therefore, follow-up observation should be emphasized in the first year after insertion.
Cannot be confirmed