Copper IUD restores menses in women with secondary amenorrhea

Jan 27 - Normal menstrual flow in young women with secondary amenorrhea is restored quickly after the insertion of a copper intrauterine device (IUD), and is maintained for up to a year after device removal, according to a report in the January issue of Fertility and Sterility.

Dr. Fortunato Vesce and colleagues from the University of Ferrara, Italy, attempted to restore menstruation with a copper IUD in 48 women with functional secondary amenorrhea. The mean age of the women in the group was 25 years, and the duration of amenorrhea ranged from 4 months to more than 10 years.

In 40 of the 48 women, normal menstrual flow was restored within a few weeks of device insertion. In the 8 women who did not respond, the device was in place for 6 months.

In the responders, normal flow was maintained as long as the device was in place--at least 1 year--and, in 23 of 28 patients, for at least 1 year after device removal. Two patients became pregnant after IUD removal.

The other 12 patients had had the IUD in place for more than 2 years at the time the report was written, and all still had regular menses.

"The high percentage of patients who responded to treatment with the copper IUD points to endometrial control of menstruation," the authors conclude. "It is possible that this control depends on the release of [prostaglandins] from the uterine mucosa that reach the ovaries and induce luteolysis."

Fertil Steril 2000;73:162-165.