THE COMPARATIVE TRIAL OF TCU 380A IUD AND PROGESTERONE-RELEASING VAGINAL RING USED BY LACTATING WOMEN

The objective of this paper was to compare the efficacy, acceptability , safety, and bleeding patterns of TCu 380A intrauterine device (IUD) and progesterone-releasing vaginal ring used by breastfeeding women. T he study population included 97 breastfeeding women using IUD and 100 women using vaginal ring. Of the IUD users, no insertion failure, perf oration, or accidental pregnancy occurred in 12 months. There was one IUD expulsion. There were no discontinuations of IUD due to medical re asons other than expulsion. The total discontinuation rate was 2.3%. I n the ring group, no accidental pregnancy occurred. The major reasons for discontinuation were ring use-related problems and vaginal problem s. The total discontinuation rate was 65.4% within 2 year. The frequen cy of any one complaint among the ring users was higher than that amon g the IUD users. There were no differences in the proportion of women having no sexual activity and in the weight of their babies between th e two groups. Compared with the IUD users, the median number of bleedi ng/spotting (B/S) episodes and B/S days of the vaginal ring users were fewer; consequently, the mean length of B/S-free interval was longer in all four reference periods; the mean length of B/S episode and segm ent were the same; the occurrence of amenorrhea was more frequent; in contrast, the proportions of normal bleeding patterns were fewer. The frequencies of prolonged bleeding, frequent bleeding, and infrequent b leeding patterns did not differ between the two groups. The percentage of irregular bleeding was fewer only in the first two reference perio ds. It is concluded that the TCu 380A IUD and progesterone-releasing v aginal ring used by breastfeeding women are safe and effective. The hi gher discontinuation rate of the ring users was mainly because of use- related problems. Breastfeeding women with TCu 380A IUD had better tol erance and acceptability. The TCu 380A IUD does not, but the progester one-releasing vaginal ring does, suppress the recovery of ovarian func tion. However, once return of menstruation occurred, there were no dif ferences in bleeding patterns between the two contraceptive methods. C ONTRACEPTION 1998;57:371-379 (C) 1998 Elsevier Science Inc. All rights reserved.