ABSTRACT
BACKGROUND: A better understanding of the uterine and endometrial vascularization in intrauterine device (IUD)-induced side effects is clearly of paramount importance in terms of both physiological and pathophysiological changes and may permit assessment for future therapeutic treatments. The aim of the study was to quantify the subendometrial microvascularization and uterine artery blood flow in IUD-induced side effects using power Doppler analysis as well as pulsatility index (PI) and resistance index (RI) in the exact midluteal phase 3 months after IUD insertion. There were 27 patients using the levonorgestrel-releasing intrauterine system and 25 patients using TCu 380A. STUDY DESIGN: This study has a prospective clinical trial design. RESULTS: There is an increased subendometrial blood flow in patients with severe dysmenorrhea and/or bleeding, after controlling for IUD type, age and parity. Moreover, the PI and RI were not different in such women. CONCLUSION: The results provide new data on the bleeding patterns related to these IUD types that may be relevant during contraception use. This method could be used as a prognostic factor to better evaluate women for the risk of developing dysmenorrhea and/or bleeding after IUD insertion.
Subject(s)
Intrauterine Devices, Copper/adverse effects , Intrauterine Devices, Medicated/adverse effects , Microvessels/physiopathology , Uterus/blood supply , Adult , Amenorrhea/etiology , Arteries/diagnostic imaging , Dysmenorrhea/diagnostic imaging , Dysmenorrhea/etiology , Dysmenorrhea/physiopathology , Female , Hemorheology , Humans , Menorrhagia/diagnostic imaging , Menorrhagia/etiology , Menorrhagia/physiopathology , Microvessels/diagnostic imaging , Pulsatile Flow , Regional Blood Flow , UltrasonographyABSTRACT
During this cohort study, the copper-intrauterine device (IUD) did not modify subendometrial microvascularization. However, subendometrial blood flow increased in patients who experienced IUD-induced side effects.