RESUMO
PIP: Menorrhagia is frequent during the 1st months following the insertion of an IUD. However if irregular bleeding persists or appears after a certain time of well tolerated IUD use, a complete examination must be performed. The patient must be questioned concerning the date of insertion and the type of IUD, and concerning the symptoms. When placing an IUD, the doctor must inform the patient of the possibility of heavier periods. No symptomatic treatment should be prescribed without performing a complete examination. The clinical examination must be followed by complementary examinations according to the clinical results. The 2 diagnoses to eliminate in priority are ectopic pregnancy and infection. The doctor should always keep in mind the possibility of ectopic pregnancy in women wearing an IUD. No IUD should be inserted in nulliparous women, nor in women with heavy periods or unexplained metrorrhagia. The contraindications concerning IUD insertions must be respected. The doctor must advise the patient to come regularly for check-ups and to consult in case of any abnormal sign.^ieng
Assuntos
Anticoncepção , Diagnóstico , Dispositivos Intrauterinos , Menorragia , Metrorragia , Comportamento Contraceptivo , Doença , Estudos de Avaliação como Assunto , Serviços de Planejamento Familiar , Hemorragia , Infecções , Distúrbios Menstruais , Paridade , Gravidez , Gravidez Ectópica , Sinais e SintomasRESUMO
PIP: In case of post oral contraception amenorrhea it would be advisable to: 1) perform a thorough gynecological examination and gather a full medical history; 2) reassure the patient, explaining that in most cases ovulation will return spontaneously; 3) if the patient wants to continue contraception, advise the use of IUD or of an intravaginal contraceptive device; and 4) if the patient wishes to become pregnant start therapy with clomiphene or bromocriptine.^ieng