Contraceptive delivery systems最新文献

Increased uterine bleeding has often been cited as a frequent side effect of IUD usage. Previous reports have consistently linked IUD usage to increased menstrual blood loss; however, the role of the IUD as an etiologic agent in the development of iron deficiency with or without anemia is still unclear. This study examines hematologic and menstrual parameters in 52 IUD subjects and 40 control subjects. 90% of subjects with an IUD reported an increase in the amount and duration of menstrual flow and 35% noted intermenstrual bleeding. However, in a group of healthy women, the use of an IUD was not associated with significant or detrimental changes in common hematologic parameters.

Fincoid, a new copper IUD, was tested on a single clinic basis in a preliminary series of 956 1st insertions and 10,015 woman-months of use with an individual follow-up of 12 months. 458 (48%) of the women were nulliparous and 498 (52%) were parous. About 1/3 of the women had previously discontinued the use of other types of IUDs (mostly copper) because of side effects. The 1st segment of net cumulative rates for the whole series were: pregnancy 1.1, expulsion 4.7, removal for bleeding and/or pain 7.6 and removal for infection 0.8. The continuation rate was 78.9 and the percentage lost to follow-up was 2.8%. The parous group had a higher continuation rate (81) than the nulliparous group (76). Rates for pregnancy, expulsion, and infection in the nulliparous group were about 2-fold the corresponding rates of the parous group. There was no difference in the removal rate for bleeding and/or pain between the 2 parity groups. The results of the study show that the Fincoid is a valid method of intrauterine contraception.

990 cases of women using standard copper IUDs (Cu 7; Cu T; Multiload) up to a maximum period of 8 years have been analyzed statistically. The long-term use effectiveness was evaluated mainly by using statistical methods (life table). Pregnancy rates decreased during the whole period of observation but more evidently after 2 years of use. It is recommended that medicated IUDs, free of side effects, be exchanged only after 5 years of use, corrosive changes being not too far advanced after this period. New IUD models are less likely to be subject to corrosion and will therefore need to be replaced less frequently.

Specimens of cervical mucus from 7 women fitted with copper IUDs were placed immediately after collection in liquid nitrogen. These specimens were shown by electron paramagnetic resonance measurements to contain statistically significantly higher concentrations of free radicals than similar specimens from 6 women fitted with plastic Lippes loops. Cervical mucus, collected from women immediately prior to elective removal of an IUD, was placed in 2M hydrochloricacid and later analyzed for malonaldehyde using a newly developed polarographic method. Positive results were obtained for 8 of 19 women fitted with copper IUDs, but for none of 21 women fitted with plastic devices. Cervical mucus was similarly collected from 10 women fitted with copper IUDs, 9 women fitted with plastic IUDs, and an additional 9 using other methods of contraception. Mucus was collected 3 times (early, middle, and late cycle). No malonaldehyde was detected in mucus from women with plastic IUDs, or other contraceptive methods. Positive results were obtained in 13 of 29 mucus specimens from those using copper IUDs. Stage of menstrual cycle did not influence the percentage of positive results. Malonaldehyde was detected in vitro in solutions of arachidonate or prostaglandin F2alpha in buffered saline incubated with sterile copper IUD, but not with the plastic. Rate of malonaldehyde production was markedly influenced by pH, temperature, agitation, substrate concentration, and size of gas-liquid interface. the rates of malonaldehyde production around the copper IUD in utero are unknown. The possible increased risk of carcinogenicity associated with the copper IUD is discussed.

The relationship of horizontal-to-vertical ratio (HVR) of 14 commonly used IUDs was compared to medical removal and expulsion rates. A significant positive statistical correlation between IUD HVR and medical removal rate existed. However, no correlation existed between HVR and expulsion. A ratio of about 0.5 for multiparous and 0.7 for nulliparous women less frequently in medical removal of the device. The endometrial cavity length sizes have boundary values on IUD width of 15-18 mm for nulliparae and 18-25 mm for multiparae. The endometrial cavity is thus functionally an isosceles triangle or isosceles trapezoid.

Sex hormone binding globulin (SHBG) has been measured using an improved ammonium-precipitation method. SHBG has been measured in normal male and female subjects, and in hirsute subjects on and off combined oral contraceptives (OCs). SHBG concentrations in hirsute subjects were significantly lower than those of normal female subjects (P0.001). During treatment with OCs, SHBG concentrations rose significantly (P0.001). Among hirsute patients, there was no significant (P0.5) difference between the pretreatment SHBG concentrations of 'responders' and those of 'nonresponders.' During treatment, SHBG concentrations increased in both groups.

Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) reduced excessive IUD-induced bleeding. The effect of 3 different oral NSAIDs, namely indomethacin, Alclofenac, and flufenamic acid, on menstrual blood loss (MBL) and pain among women fitted with copper IUDs was studied and compared with a placebo on a randomized single blind basis. Each drug was given to 6 subjects (18 cases) over 2 consescutive cycles and was either preceded or followed by placebo for 2 more cycles. 1/2 of the cases on each drug started placebo medication in the 1st 2 months while the other 1/2 started by the drug. The oral treatment was begun on the 1st day of menstrual bleeding or spotting. Estimation of the daily MBL was done by the alkaline hematin method with mechanical extraction of sanitary pads. The 3 drugs tested in this study induced a significant reduction in MBL: maximum reduction by flufenamic acid medication, less with Alclofenac, and least with indomethacin medication. However, these reductions were not statistically different, and marked improvement in IUD-induced pain was observed under the effect of the 3 drugs.