Bleeding and Cramping in the First 90 Days After Copper or Levonorgestrel Intrauterine Device Placement.

IF 3.1 2区医学 Q1 DEMOGRAPHY

Perspectives on Sexual and Reproductive Health Pub Date : 2026-09-07 DOI:10.1111/psrh.70088

Siripanth Nippita, Anna Merport Modest, Carolyn L Westhoff, Paula M Castaño, Johana Oviedo, Katherine Rivlin

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Abstract

Introduction: We describe bleeding and cramping patterns during the first 90 days after intrauterine device (IUD) placement.

Methods: This was a planned sub-analysis of a prospective cohort study of IUD users in the United States who initiated the copper T380A (Cu-IUD) or the levonorgestrel 52 mg intrauterine device (LNG IUD) at any time in the menstrual cycle. Participants rated bleeding and cramping from 1 (no bleeding or cramping) to 4 (heavy bleeding or severe cramping). We included participants providing ≥ 60 days of continuous responses and described overall bleeding/cramping.

Results: Of 230 participants enrolled, 137 (60%) met inclusion criteria (Cu-IUD n = 69, 50% and LNG IUD n = 68, 50%). Cu-IUD users reported fewer days with any bleeding (26 days, IQR 18-31) compared with LNG IUD users (38 days, IQR 27-55, p < 0.001). LNG IUD users reported more spotting days (median 31 [IQR 17-41] vs. 13 [IQR 10-20], p < 0.01). Total bleeding/spotting days were similar for each IUD type regardless of placement timing or prior contraceptive method. Median reported cramping days were similar for both IUDs (Cu-IUD 18, IQR 7-29 and LNG IUD 18, IQR 10-38, p = 0.18). Cramping was most common in the week following placement for both IUD types, decreased over the 90-day period, and did not vary by IUD type.

Conclusion: LNG IUD users reported more days with any bleeding in the first 90 days after placement overall compared with Cu-IUD users, largely driven by more than twice the number of spotting days. Cramping was most common in the first week following IUD placement and decreased over time.

Trial registration: Clinicaltrials.Gov Identifier: NCT01730911.

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放置铜或左炔诺孕酮宫内节育器后90天出血和痉挛。

简介：我们描述在放置宫内节育器（IUD）后的前90天出血和痉挛模式。方法：这是一项针对美国在月经周期任何时间开始使用铜T380A （Cu-IUD）或左炔诺孕酮52 mg宫内节育器（LNG IUD）的宫内节育器使用者的前瞻性队列研究的计划亚分析。参与者对出血和痉挛的评分从1（没有出血或痉挛）到4（大出血或严重痉挛）。我们纳入了持续反应≥60天的参与者，并描述了总体出血/痉挛。结果：入选的230名参与者中，137名（60%）符合纳入标准（Cu-IUD n = 66,50%, LNG IUD n = 66,50%）。与LNG节育器使用者（38天，IQR 27-55, p）相比，cu节育器使用者报告的出血天数更少（26天，IQR 18-31）。结论：与cu节育器使用者相比，LNG节育器使用者在放置后的前90天报告的出血天数更多，主要是由于出血天数的两倍多。痉挛在放置宫内节育器后的第一周最常见，并随着时间的推移而减少。试验注册：临床试验。政府标识符：NCT01730911。

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来源期刊

Perspectives on Sexual and Reproductive Health Multiple-

CiteScore

5.10

自引率

3.40%

发文量

期刊介绍： Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.