Menstrual-Related Side Effects After Intrauterine Device Insertion or Tubal Ligation

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SCIENCE
Menstrual-Related Side Effects After Intrauterine Device Insertion or Tubal Ligation
Key Take-Away: 

The most widely used reversible method of contraception is the intrauterine device (IUD). Tubal ligation is surgery to close a woman's Fallopian tubes to prevent pregnancy. The prevalence of manifestations of the menstrual problems like dysmenorrhea, menorrhagia, anemia etc. of IUD and tubal ligation was compared in this study.

This retrospective claims database analysis compares menstrual-related side effects associated with the insertion of an intrauterine device (IUD) or tubal ligation.

ABSTRACT: 
Background: 

This retrospective claims database analysis compares menstrual-related side effects associated with the insertion of an intrauterine device (IUD) or tubal ligation.

Methods: 

The Clinformatics DataMart database from January 1, 2006, to September 30, 2012, was used.

Women between ages 15 and 45 years were required to have an IUD inserted (Paragard or Mirena) or a tubal ligation (identified as index date) and have continuous insurance coverage from 1 year prior (preperiod) through 1 year postindex date (postperiod). [chi]2 statistics assessed associations between preperiod and postperiod menstrual-related side effects.

Results: 

The sample consisted of 107,516 women (11,864 Paragard; 56,661 Mirena; 38,991 tubal ligation).

The majority were age 25-34 years (46.20%) or 35-45 years (45.22%), resided in the South (49.96%), and had point of service insurance (68.46%). There were significant differences in both preperiod and postperiod rates of dysmenorrhea, heavy menstrual bleeding, menorrhagia, anemia, and amenorrhea (all P<.001) among the three groups. Women who received a tubal ligation had the highest rates of preperiod and postperiod dysmenorrhea (3.93%; 4.77%), heavy menstrual bleeding (10.19%; 15.81%), menorrhagia (0.48%; 0.72%), and anemia (3.11%;3.49%) and the highest preperiod rate of amenorrhea (21.60%). In contrast, women who used Paragard had the lowest reported rates of preperiod dysmenorrhea (1.47%), heavy menstrual bleeding (2.43%), menorrhagia (0.15%), anemia (2.31%), and postperiod menorrhagia (0.23%), whereas those who used Mirena had the lowest preperiod rates of amenorrhea (14.23%) and postperiod dysmenorrhea (2.27%), heavy menstrual bleeding (6.54%), anemia (1.82%), and amenorrhea (3.32%).

Conclusion: 

Tubal ligation, compared with IUD insertion, is generally associated with higher rates of menstrual-related side effects.

Obstetrics and Gynecology 2015 May;125 Suppl 1-79S

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