Long-acting reversible contraceptives effects in abnormal uterine bleeding, a review of the physiology and management

Karina Castillo, Kevin Zambrano, Diego Barba, Paola Robayo, Serena Sanon, Andres Caicedo*, Alfredo Jose Jijon Chiriboga*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Around two-thirds of women who are of reproductive age use some type of contraception. Two of the most effective long-acting reversible contraceptives (LARC) are the intrauterine device (IUD) and the subdermal contraceptive implant (SCI). Despite their effectiveness, women often report abnormal uterine bleeding as the reason for discontinuation. In this review, we analyze key aspects regarding the mechanisms of action of IUDs (both copper-containing and levonorgestrel-releasing) and SCIs, as well as how they change the intrauterine environment in order to provide effective contraception at a physiological level. Additionally, we introduce the pathophysiology of different types of abnormal intrauterine bleeding provoked by the mentioned LARCs. These three contraceptive methods work in diverse ways, thus, the etiology of abnormal uterine bleeding is different and multifactorial according to each LARC. This review intends to provide information in order to better our understanding of bleeding induced by these contraceptive methods, as well as introduce current and potential new therapies. Furthermore, this review intends to provide updated and concise information that could be available firsthand not only to health care providers but scientists who are innovating and revolutionizing this field. In 2013, the American College of Obstetricians and Gynecologists published a management of abnormal uterine bleeding, however, there is limited updated data regarding the physiology and pathophysiology of abnormal uterine bleeding and its treatment based on different LARCs (hormonal and non-hormonal).

Original languageEnglish
Pages (from-to)231-238
Number of pages8
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Volume270
DOIs
Publication statusPublished - Mar 2022

Keywords

  • Contraception/methods
  • Contraceptive Agents
  • Contraceptive Agents, Female/adverse effects
  • Female
  • Humans
  • Intrauterine Devices
  • Intrauterine Devices, Copper/adverse effects
  • Intrauterine Devices, Medicated/adverse effects
  • Levonorgestrel/adverse effects
  • Uterine Hemorrhage/drug therapy
  • LARCs
  • VITAMIN-E
  • EFFICACY
  • Amenorrhea
  • IUD
  • IRREGULARITIES
  • Abnormal uterine bleeding
  • LEVONORGESTREL INTRAUTERINE SYSTEM
  • ACCEPTABILITY
  • DEVICE USE
  • TRANEXAMIC ACID
  • WOMEN
  • IMPLANT
  • USERS
  • Dysmenorrhea
  • Subdermal contraceptive implant

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