Bleeding
Ensure potential Cu-IUD users are informed about possible bleeding pattern changes, to inform decision-making and improve satisfaction rates.
The Cu-IUD has been associated with an increase in menstrual blood loss and intermenstrual bleeding, secondary to increased release of prostaglandin and other vasoactive agents within the endometrium as part of an inflammatory response.
Bleeding may be heavier, longer or more painful than prior to Cu-IUD insertion and users may experience intermenstrual bleeding.
Increased menstrual bleeding will often decrease over time; however, intermenstrual bleeding is less likely to do so.
As with other LARC methods, increased bleeding is often cited as the most common reason for discontinuation of a Cu-IUD. However, continuation rates for Cu-IUDs are high, suggesting that in spite of this the method is often highly acceptable.
Other Side effects
For most users a Cu-IUD has either no impact or a positive impact on sexual experiences.