DETAILED ANALYSIS OF MENSTRUAL BLEEDING PATTERNS AFTER POSTMENSTRUAL AND POSTABORTAL INSERTION OF A COPPER IUD OR A LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM

Detailed information on the menstrual bleeding patterns in users of co pper-releasing intrauterine devices (IUDs) and levonorgestrel-releasin g intrauterine systems (IUSs) is lacking. Even less is known about the menstrual bleeding patterns associated with postabortal insertion of IUDs. We postulated that the scarcity of IUD studies including detaile d analysis of bleeding could be a result of the lack of an easy-to-use computer program designed for this purpose. We therefore developed a set of graphical user interface (Windows) programs for entering, editi ng and analyzing menstrual diary data. With these programs, we reanaly zed the menstrual diaries of the subjects of one of the hospital clini cs that participated in a previous multicenter study comparing copper IUDs and LNg IUSs. The group included patients who had the IUD inserte d postabortally. Copper IUD users had patterns of bleeding that were s table over time, and clearly more bleeding than LNg IUS users, many of whom had either infrequent bleeding, bleeding completely replaced by regularly occurring spotting, or amenorrhea. Postabortal insertion of LNg IUSs was associated with slightly better patterns of bleeding than postmenstrual insertion. Detailed statistics on bleeding help clinici ans in counseling patients regarding these methods. The statistics per mit assumptions to be made about the probabilities of specific menstru al disturbances and their changes over time. (C) 1996 Elsevier Science Inc.