THE LONG-TERM EFFECTS OF COPPER SURFACE-AREA ON MENSTRUAL BLOOD-LOSS AND IRON STATUS IN WOMEN FITTED WITH AN IUD

The long-term effects of copper surface area on menstrual blood loss ( MBL) and iron status (hemoglobin, hematocrit, red cell count and indic es, and serum ferritin) were evaluated in 25 healthy women who were ob served for a period of 3 years following insertion of an intrauterine device. MBL was determined objectively by the alkaline hematin method. The women (mean age 37.2 +/- 1.6 yr, range 27-46 yr) were fitted with a Multiload intrauterine device (IUD) with a copper surface area of e ither 250 mm2 (MLCu-250, n =,13) or 375 MM2 (MLCu-375, n = 12). MBL pr ior to IUD insertion was 55 +/- 8 ml for women subsequently fitted wit h a MLCu-250 and 59 +/- 9 ml for women fitted with a MLCu-375. An incr ease in MBL was recorded at all measurement points following IUD inser tion (MLCu-250/MLCu-375: 3 months: 55/49%; 6 months: 58/49%; 12 months : 64/41%; 24 months: 55/49%; 36 months: 47/39%, NS). There were no sig nificant differences in iron status parameters before IUD insertion be tween groups nor were there any significant changes recorded in any of these parameters after IUD insertion. Our findings that the increase in copper surface area from 250 mm2 to 375 MM2 had no effect on MBL we re thus substantiated by the hematological findings. Based on the resu lts of the present study, women from developed countries apparently to lerate an increased MBL of approximately 45% without developing anemia . Iron stores were unchanged indicating an adequate adaptive increase in intestinal iron absorption.