Prevalence of Mastalgia and the complications attributed to it following Mirena Intrauterine device Insertion: A prospective cohort study

Document Type : Original Article

Authors

1 Department of Surgery, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

10.22034/ncm.2023.405960.1098

Abstract

Background: The unprecedented increase in population around the globe has led to considering family planning policies in recent decades. Intrauterine device (IUD) is one of the most effective methods of contraception; yet, this method is associated with complications and problems that cause its removal.
Objectives: This study aims to evaluate mastalgia and the complications attributed to it following Mirena IUD in women referring to medical centers in Yazd.
Methods: In this prospective cohort study, 201 women using Mirena IUD who referred to the Gynecology Ward of two public and private hospitals in Yazd province were followed up for 6 months from November 2021 to June 2022. Data were gleaned using a data questionnaire including age, parity, duration of IUD use, and IUD complications and analyzed with SPSS22 using descriptive and analytical statistical chi-square.
Results: Of 201 women studied, 48 (36.9%) reported mild mastalgia, 7 (3.5%) had moderate mastalgia, and 12 (6%) reported severe mastalgia after IUD insertion. After 6 months, 54 (37.9%) participants had mild mastalgia, 10 (5%) reported moderate mastalgia, and 12 (6%) reported severe mastalgia. Moreover, among the complications of IUD, menstrual spotting was reported in the majority of participants (57.2%), followed by pelvic pain (28.9%), dyspareunia (27.9%), and nausea (17.4%) as the most common complications, respectively.
Conclusion: According to this study, mastalgia in women using IUD is the most common complication, second to abnormal uterine bleeding, and is not related to the age and parity of the participants. Also, IUD breast complications are relatively common, and more studies are needed to investigate these complications.

Keywords

Main Subjects


  1. Peipert JF, Zhao Q, Schreiber CA, Teal S, Turok DK, Natavio M, et al. Intrauterine device use, sexually transmitted infections, and fertility: a prospective cohort study. American Journal of Obstetrics and Gynecology. 2021;225(2):157-9. doi:10.1016/j.ajog.2021.03.011 PMid:33716075
  2. Wheeler LJ, Desanto K, Teal SB, Sheeder J, Guntupalli SR. Intrauterine device use and ovarian cancer risk: a systematic review and meta-analysis. Obstetrics & Gynecology. 2019; 134 (4): 791-800. doi:10.1097/AOG.0000000000003463 PMid:31503144
  3. Averbach SH, Ermias Y, Jeng G, Curtis KM, Whiteman MK, Berry-Bibee E, et al. Expulsion of intrauterine devices after postpartum placement by timing of placement, delivery type, and intrauterine device type: a systematic review and meta-analysis. American journal of obstetrics and gynecology. 2020;223(2):177-88. doi:10.1016/j.ajog.2020.02.045 PMid:32142826 PMCid:PMC7395881
  4. Ti AJ, Roe AH, Whitehouse KC, Smith RA, Gaffield ME, Curtis KM. Effectiveness and safety of extending intrauterine device duration: a systematic review. American journal of obstetrics and gynecology. 2020;223(1):24-35. doi:10.1016/j.ajog.2020.01.014 PMid:31954154
  5. Temel Yüksel İ, Erdem B, Aslan Çetin B, Duğan Köroğlu N, Dansuk R. Effect of the levonorgestrel-releasing intrauterine system on the uterine artery, uterine volume, and endometrium in endometrial hyperplasia without atypia. Endometrial Hyperplasia without Atipia. 2019; 9(1):15-8. doi:10.5152/jarem.2019.2470
  6. Achilles SL, Chen BA, Lee JK, Gariepy AM, Creinin MD. Acceptability of randomization to levonorgestrel versus copper intrauterine device among women requesting IUD insertion for contraception. Contraception. 2015;92(6):572-4. doi:10.1016/j.contraception.2015.08.009 PMid:26297203 PMCid:PMC4654647
  7. Bilgehan F, Dilbaz B, Karadag B, Deveci CD. Comparison of copper intrauterine device with levonorgestrel‐bearing intrauterine system for post‐abortion contraception. Journal of Obstetrics and Gynaecology Research. 2015;41(9):1426-32. doi:10.1111/jog.12747 PMid:26180028
  8. Miranda MT, Simó PA. Ethical Aspects of the Use of Mirena (r) Iud in the Treatment of Heavy Menstrual Bleeding. Cuadernos de bioetica: revista oficial de la Asociacion Espanola de Bioetica y Etica Medica. 2018;29(96):159-76.
  9. Goldstuck ND, Cheung TS. The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update. International journal of women's health. 2019;11:471. doi:10.2147/IJWH.S213815 PMid:31686919 PMCid:PMC6709799
  10. Hubacher D, Schreiber CA, Turok DK, Jensen JT, Creinin MD, Nanda K, et al. Continuation rates of two different-sized copper intrauterine devices among nulliparous women: Interim 12-month results of a single-blind, randomised, multicentre trial. E Clinical Medicine. 2022; 51:1-12. doi:10.1016/j.eclinm.2022.101554 PMid:35865736 PMCid:PMC9294241
  11. Wemrell M, Gunnarsson L, editors. Claims in the clinic: tensions in healthcare communication about perceived side effects of the copper IUD. Futures Ahead-Translations and collaborations between medicine, social science and the humanities; 2022.Bahamondes L, Brache V, Meirik O, Ali M, Habib N, Landoulsi S, et al. A 3-year multicentre randomized controlled trial of etonogestrel-and levonorgestrel-releasing contraceptive implants, with non-randomized matched copper-intrauterine device controls. Human Reproduction. 2015;30(11):2527-38. doi:10.1093/humrep/dev221 PMid:26409014
  12. Moray KV, Chaurasia H, Sachin O, Joshi B. A systematic review on clinical effectiveness, side-effect profile and meta-analysis on continuation rate of etonogestrel contraceptive implant. Reproductive Health. 2021;18(1):1-24. doi:10.1186/s12978-020-01054-y PMid:33407632 PMCid:PMC7788930
  13. Makins A, Taghinejadi N, Sethi M, Machiyama K, Munganyizi P, Odongo E, et al. FIGO postpartum intrauterine device initiative: Complication rates across six countries. International Journal of Gynecology & Obstetrics. 2018;143:20-7. doi:10.1002/ijgo.12600 PMid:30225873
  14. Pfitzer A, Mackenzie D, Blanchard H, Hyjazi Y, Kumar S, Lisanework Kassa S, et al. A facility birth can be the time to start family planning: postpartum intrauterine device experiences from six countries. International Journal of Gynecology & Obstetrics. 2015;130:S54-S61. doi:10.1016/j.ijgo.2015.03.008 PMid:26115859
  15. López-Farfan JA, Hernandez-Gonzalez A, Vélez-Machorro IJ, Vázquez-Estrada LA. A comparative, randomized study of levonorgestrel intrauterine system (LNG-IUS) vs Copper T 380 A intrauterine device applied during cesarean section. Open Journal of Obstetrics and Gynecology. 2012;2(2):151-5. doi:10.4236/ojog.2012.22029
  16. Sakinci M, Ercan CM, Olgan S, Coksuer H, Karasahin KE, Kuru O. Comparative analysis of copper intrauterine device impact on female sexual dysfunction subtypes. Taiwanese Journal of Obstetrics and Gynecology. 2016;55(1):30-4. doi:10.1016/j.tjog.2014.12.011 PMid:26927244