الفهرس 
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Abstract
Intra Uterine Devices are exceptionally effective contraception. Menorrhagia and dysmenorrhoea are also reduced by the LNG-IUS. The dropout rate, mostly for menstruation issues, is the biggest hurdle to long-term success. Despite the fact that IUDs are the most extensively used reversible form of family planning in the world, use would be even higher if not for limitations in device and provider availability, as well as misplaced concern about the possibility of infection.
The LNG-IUS has been shown to be a viable alternative to hysterectomy and endometrial ablation. Many surgical operations are still carried out without first considering the LNG-IUS or other medicinal therapies. The LNG-IUS is not only very successful at reducing heavy menstrual bleeding, but it is also well tolerated, has a high user satisfaction rate, and is cost effective.
Increased uterine bleeding and increased menstrual discomfort are the most common reasons for IUD cessation after one year; 5-10% of women stop IUD usage due to these concerns.
Smaller copper and progestin IUDs have significantly lowered the incidence of discomfort and bleeding. Because bleeding and discomfort are at their worst in the first few months following IUD installation, using non steroidal anti-inflammatory medicines during the first few menstrual cycles can help lessen bleeding and cramping. Although heavy menstruation can be adequately managed with NSAIDs.
silver is used in IUDs to promote menstrual blood loss. In developing countries with women who are already depleted in body iron stores may prove to be extremely harmful to their health.
IUD-related uterine hemorrhage is considered to as iatrogenic dysfunctional uterine bleeding. The bleeding caused by IUD usage can occur during menstruation (heavy and/or extended) or as inter menstrual bleeding and spotting.
The IUD causes more menstrual bleeding by interfering with numerous components of endometrial hemostasis. Some prostaglandins may increase vascularity and permeability, while others decrease platelet function. Increased prostaglandin production may contribute to endometrial hemorrhage synthesis and release in IUD-exposed endometrium. IUD-induced menorrhagia may be associated with impaired contractility of spiral arterioles in the endometrium’s spontaneous layer. Increased fibrinolysis with IUD is also likely to occur as a result of capillary plexus damage, which causes increased and extended menstrual bleeding.
In addition, two dimensional ultrasonography offers valuable information on the position of the IUD after insertion. And two dimensional ultrasonography allows for simultaneous imaging of the whole IUD, including the shaft and arms. Furthermore, using this innovative technology, examination time may be minimized .
Transvaginal color Doppler sonography can assess the hemodynamic changes in the uterine vascular bed following the insertion of an intrauterine device (IUD) and determine whether those color Doppler findings can predict potential side effects such as dysmenorrhea and abnormal bleeding.
This study involves 100 patients separated into two groups: study (50 women) and control (50 women). The study group has menorraghea with an IUD, but the control group does not have any menorraghea with an IUD. In both groups, the IUD-FD, IUD-MD, IUD-ED, IUD-IOD, endometrial thickness, uterine size, and uterine Doppler were measured. The goal was to discover whether there is a link between the site of the IUD and irregular uterine bleeding.
There was no statistically significant difference between the two groups in terms of age, parity, length of usage, uterine size, or endometrial thickness. However, it was discovered that there is a statistically significant difference between the two groups when IUD-F, IUD-M, IUD-E, and IUD-IO distances are included, indicating a probable association between IUD position and irregular uterine bleeding.
It was discovered that abnormal uterine bleeding associated with IUD is reduced when the IUD is placed closer to the fundus and further away from the internal os. The IUD-F, IUD-M, and IUD-E distances have a direct association with the incidence of abnormal uterine bleeding and pain, while the IUD-IO distance has a relationship with the occurrence of abnormal uterine bleeding and pain.
As regard to Doppler findings, it was noted that RI was significantly lower in group I in contrast to group II (P< 0.001) and Pulsitility index (PI) followed the same pattern as RI.
We may infer that PI and RI were considerably lower in women who had IUD-induced abnormal bleeding than in those who did not have abnormal vaginal bleeding but used an IUD. Our findings support the idea that individuals with IUD-induced irregular vaginal bleeding have increased uterine artery blood flow (as evidenced by lower PI and RI). Furthermore, detecting PI and RI in the uterine arteries might be utilized to identify individuals at risk of suffering excessive bleeding following copper IUD insertion.