Therapeutic Options for Unscheduled Bleeding Associated with Long-Acting Reversible Contraception

EmmaKate Friedlander; Bliss Kaneshiro

doi:10.1016/j.ogc.2015.07.004

Therapeutic Options for Unscheduled Bleeding Associated with Long-Acting Reversible Contraception

Obstet Gynecol Clin North Am. 2015 Dec;42(4):593-603. doi: 10.1016/j.ogc.2015.07.004. Epub 2015 Sep 16.

Authors

EmmaKate Friedlander¹, Bliss Kaneshiro²

Affiliations

¹ Family Planning Division, Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, #824, Honolulu, HI 96826, USA. Electronic address: emmakate@hawaii.edu.
² Family Planning Division, Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, #824, Honolulu, HI 96826, USA.

PMID: 26598302
DOI: 10.1016/j.ogc.2015.07.004

Abstract

Long-acting reversible contraception (LARC) is the most effective form of reversible contraception. Although most women are satisfied with LARC methods, unscheduled bleeding and spotting are common reasons for method dissatisfaction and discontinuation. This systematic analysis of the current literature delineates treatment options for unscheduled bleeding related to LARC use. Although consistent results are lacking, all devices seem to have the best response to nonsteroidal antiinflammatory drugs for 5 to 7 days or the antifibrinolytic agent tranexamic acid. Additional studies are necessary to identify improved treatment interventions for unscheduled bleeding with LARC use.

Keywords: Contraceptive implant; Etonogestrel; Intrauterine device; Irregular bleeding; Levonorgestrel.

Publication types

Review

MeSH terms

Adult
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Antifibrinolytic Agents / therapeutic use
Contraception / adverse effects*
Doxycycline / therapeutic use
Female
Hormone Antagonists / therapeutic use
Humans
Intrauterine Devices, Copper / adverse effects*
Intrauterine Devices, Medicated / adverse effects*
Levonorgestrel
Matrix Metalloproteinase Inhibitors / therapeutic use
Mifepristone / therapeutic use
Practice Guidelines as Topic
Time Factors
Tranexamic Acid / therapeutic use
Uterine Hemorrhage / drug therapy
Uterine Hemorrhage / etiology
Uterine Hemorrhage / prevention & control*

Substances

Anti-Inflammatory Agents, Non-Steroidal
Antifibrinolytic Agents
Hormone Antagonists
Matrix Metalloproteinase Inhibitors
Mifepristone
Levonorgestrel
Tranexamic Acid
Doxycycline