Comparative quantitation of menstrual blood loss with a d-norgestrel-releasing IUD and a Nova-T-copper device

doi:10.1016/0010-7824(77)90001-4

Contraception

Volume 15, Issue 4, April 1977, Pages 379-387

https://doi.org/10.1016/0010-7824(77)90001-4 Get rights and content

Abstract

A quantitative determination of menstrual blood loss by the Hallberg-Nilsson method was performed on users of a d-nor-gestrel-releasing IUD and a Nova-T-copper-IUD. The mean blood loss for three consecutive menstrual periods was found to be 20.7 ± 6.0 ml for the d-norgestrel-releasing IUD and 72.5 ± 6.2 ml for the Nova-T IUD users. Compared to the preinsertion control menstrual blood loss, there was a highly significant decrease in the d-norgestrel-releasing IUD group and a significant rise of blood loss in the Nova-T IUD group. Although changes in hemoglobin concentrations were not statistically significant, a rise in the hemoglobin concentration for the d-norgestrel-releasing IUD group was seen, whereas a slight decrease occurred in the Nova-T IUD group.

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Cited by (81)

The current status of hormonal therapies for heavy menstrual bleeding
2017, Best Practice and Research: Clinical Obstetrics and Gynaecology
Citation Excerpt :
Studies on the intrauterine release of LNG for contraception through intrauterine device began in the 1970s [12]. When testing the first experimental LNG-IUS, it soon became evident that uterine bleeding is strongly reduced with LNG-IUS use [13]. The therapeutic potential of the LNG-IUS was rapidly tested in women suffering from HMB by Andersson and Rybo [14] and Milsom et al. [15].
Hormonal treatment of abnormal uterine bleeding (AUB), especially bleeding related to endometrial causes (AUB-E), ovulatory dysfunction (AUB-O) and coagulopathy (AUB-C), and to some extent, uterine leiomyomas and adenomyosis, has become the first-line evidence-based management strategy during recent years. Hormonal treatment of heavy menstrual bleeding (HMB) is also endorsed as the first line of treatment in several international guidelines.
In the present article, we review the efficacy of the commonly used and widely available hormonal treatments of AUB-O, AUB-E and AUB-C. The therapies include combined hormonal contraceptives, progestin-only preparations, and intrauterine release of levonorgestrel through the levonorgestrel-releasing intrauterine system. In addition, we make practical recommendations for patient management.
We also review some of the current guidelines and their recommendations concerning the treatment of HMB. Finally, the effects of hormonal treatment on the overall management of AUB and its effects on the health care system and specialist training are discussed.
The effect of levonorgestrel-releasing intrauterine device on menorrhagia in women taking anticoagulant medication after cardiac valve replacement
2009, Contraception
Citation Excerpt :
Insulin-like growth factor-1 modulates the mitogenic action of estrogen, and its suppression may have an additional effect on endometrial atrophy [24,25]. This strong endometrial suppression leads to a reduction in menstrual blood loss [26,27]. In a multicenter randomized trial, 17% of LNG-IUD users experienced amenorrhea in 1 year [28], whereas 30% did in 2 years in another trial [29].
This study was conducted to evaluate the effect of levonorgestrel-releasing intrauterine devices (LNG-IUDs) on menorrhagia in patients receiving anticoagulant therapy after cardiac valve replacement.
Forty women with menorrhagia who underwent cardiac valve replacement and were taking anticoagulant medication were enrolled in the study. The women were randomly divided into two groups: LNG-IUDs were inserted into 20 women in Group 1 over the first 3 days of menstrual bleeding, while the women in Group 2 were followed without any intervention. The activated partial thromboplastin time, prothrombin time, international normalized ratio, hematocrit level, hemoglobin level, ferritin level and pictorial bleeding assessments for the quantity of menstrual bleeding were recorded.
Three months after insertion of LNG-IUDs, the women in Group 1 had a significant decrease in blood loss and higher hemoglobin, hematocrit and ferritin values. No difference was detected for these parameters in the control group at the third and sixth months of the study. Coagulation parameters did not differ between the two groups.
LNG-IUDs can be considered as an effective non-surgical treatment for menorrhagia in women receiving anticoagulant therapy after cardiac valve replacement.
Hormonal contraception: recent advances and controversies
2008, Fertility and Sterility
Citation Excerpt :
The LNG-IUD has a failure rate between 0 and 0.2 per 100 woman-years (11); the ectopic pregnancy rate is 0.02 per 100 woman years (12). Menstrual bleeding is decreased by 75% in LNG-IUD users and is attributed to the progestin-induced decidualization and suppression of the endometrium (13); 20% to 50% of users become amenorrheic within the first 2 years after insertion (14). After removal, there is rapid return to normal fecundability, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age (15).
Levonorgestrel-releasing intrauterine system vs. transcervical endometrial resection for dysfunctional uterine bleeding
2006, International Journal of Gynecology and Obstetrics
To compare the acceptability, efficacy, adverse effects, and user satisfaction of a levonorgestrel intrauterine system (LNG-IUS) and transcervical resection of the endometrium (TCRE) for the treatment of dysfunctional uterine bleeding.
Of 50 women with a pictoral blood loss assessment chart (PBAC) score of 100 or greater, 25 had a LNG-IUS inserted (Mirena; Schering, Berlin, Germany) and 25 underwent TCRE. Procedure-related complications, PBAC score, hemoglobin levels, adverse effects, and rates of acceptability and satisfaction were recorded at 3-month intervals for a period of 12 months.
At the end of 1 year there were a 97% and a 94% reduction in menstrual blood loss in the LNG-IUS and TCRE groups, respectively, and hemoglobin concentration had increased by 5.5% in the LNG-IUS group and 5.2% in the TCRE group. Adverse effects were similar in both groups except for systemic effects, which were seen only in the LNG-IUS group. Satisfaction rates were about 80% in the 2 groups.
Both treatments were found to be equally effective but LNG-IUS placement requires less operator skill and entails no operative hazards, and the device provides effective contraception.
Hormonal contraception: recent advances and controversies
2006, Fertility and Sterility
Citation Excerpt :
The LNG-IUD has a failure rate between 0 and 0.2 per 100 woman-years (11); the ectopic pregnancy rate is 0.02 per 100 woman years (12). Menstrual bleeding is decreased by 75% in LNG-IUD users and is attributed to the progestin-induced decidualization and suppression of the endometrium (13); 20% to 50% of users become amenorrheic within the first two years after insertion (14). Following removal, there is rapid return to normal fecundability with one-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age (15).
Hormonal contraception: Recent advances and controversies
2004, Fertility and Sterility

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Comparative quantitation of menstrual blood loss with a d-norgestrel-releasing IUD and a Nova-T-copper device

Abstract

Contraception

Contraception

Contraception

Am. J. Obstet. Gynecol.

Contraception

Contraception

Lancet

Evaluation of intrauterine devices, Ninth Progress Report of the Cooperative Statistical Program

Studies in Family Planning

Menstrual bleeding with intrauterine contraceptive devices

Acta Obstet. Gynecol. Scand.