Contraception Clinical Trial
Official title:
Action of Ibuprofen on IUD-associated Heavy Menstrual Bleeding
The Copper intrauterine device is the most common method of reversible contraception
worldwide. Abnormal uterine bleeding and pain are the most common medical indications for
the discontinuation of the intrauterine device.
Excessive prostaglandin release in the endometrial cavity appears to play an important role
in both bleeding and pain related to copper intrauterine devices.There are many types of
prostaglandin metabolites that present in the endometrium one of them is prostacyclin which
causes vasodilatation and inhibits platelet aggregation. Another one is thromboxane which
has two types; A2 which is active and rapidly converted into B2, which is inactive.
Thromboxane causes vasoconstriction and blood clotting.
Non-steroidal anti-inflammatory drugs (NSAIDs) are prostaglandin synthetase inhibitors
acting by decreasing production of endometrial prostaglandins; they can improve both heavy
uterine bleeding and pain. Since its discovery; several drugs in NSAIDs class have been used
to treat heavy uterine bleeding and pain associated with copper intrauterine device use such
as mefenamic acid, ibuprofen and naproxen.
The most recent systematic review found NSAIDs is the most widely studied drugs for
reduction of the menstrual blood and pain associated with copper intrauterine device. The
Cochrane Review also found that NSAIDs are the most effective treatment to reduce the
bleeding with copper intrauterine device use.
n/a
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