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 menstrual flow increased for the first two months, and then decreased by three months compared to before the implantation. Her menstrual cycle is 30 days. Is this normal?Doctor's answer:
Hello:Side Effects of IUDs:
1. Bleeding
Currently, it is believed that the increased activity of fibrinolytic enzymes caused by the IUD is the main reason for bleeding. Antifibrinolytic drugs, such as 6-aminocaproic acid, can reduce bleeding. Mild, irregular vaginal bleeding often does not require treatment; for heavier bleeding, medication to stop bleeding may be administered. If treatment is ineffective, the IUD can be removed. In cases of prolonged bleeding, infection control measures 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, poor disinfection or non-sterile procedures can lead to ascending infections. If an infection occurs, the IUD should first be removed, followed by appropriate treatment.
4. IUD Implantation
In rare cases, an 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 risk of (blindness) during the operation. If the IUD is embedded very deeply, even protruding through the uterine wall into the pelvic cavity, surgical removal (laparotomy or laparoscopy) 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, not being placed at the bottom of the uterine cavity, poor-quality materials, 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