Management of amenorrhea due to contraceptive injectables by temporary IUD insertion.

Abstract

Amenorrhea is a common side effect of injectable contraceptive. Lippes loops were inserted in 22 amenorrheic women who continued injectable contraception, and in 6 cases with prolonged postinjectable amenorrhea. The occurrence and rhythm of subsequent bleeding was recorded. IUD insertion induced bleeding in most cases of continued injectable users but it was usually irregular and unpredictable. It was regular in 6 subjects only while the IUD was in situ. After the removal of the IUD, the majority regained the state of amenorrhea within 3 months. Temporary IUD insertion had a positive impact on continuation (a mean additional rate of 18 months of use) among subjects who had wished to terminate the method because of amenorrhea. This procedure of temporary IUD insertion may serve to provide these women with an alternative contractive approach. In the postinjectable amenorrhea group, temporary IUD insertion induced bleeding during IUD application as well as after its removal, which was more predictable than that in the continued users. IUD insertion may facilitate return of regular menses and resumption of fertility in amenorrheic women who stop injectable contraception.