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Contraception. 1990 Mar;41(3):271-81.

The influence of copper surface area on menstrual blood loss and iron status in women fitted with an IUD.

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Department of Obstetrics & Gynecology, Gothenburg University, Sweden.


The influence of copper surface area on menstrual blood loss (MBL) was evaluated in 34 healthy women (mean age 36.4 +/- 1.4 yr, range 27-46 yr), who were fitted with a Multiload intrauterine device (IUD) with either 250 mm2 (MLCu-250) or 375 mm2 (MLCu-375) copper wire. MBL prior to IUD insertion was 54.4 +/- 10.3 ml for women subsequently fitted with a MLCu-250 and 56.9 +/- 6.9 ml for women fitted with a MLCu-375. An increase (p less than 0.01) in MBL was recorded 3 months after IUD insertion for both the women fitted with a MLCu-250 (86.4 +/- 10.3 ml) and a MLCu-375 (81.1 +/- 8.3 ml). This increase in MBL remained unchanged throughout the study period of one year. At no point were there any significant differences in MBL or increase in MBL between women fitted with a MLCu-250 or MLCu-375. There were no significant differences in serum ferritin, blood hemoglobin, hematocrit or erythrocyte indices before IUD insertion in the women grouped according to type of IUD, nor were any significant changes recorded in any of these parameters after IUD insertion. Thus, our findings that the increase in copper surface area from 250 mm2 to 375 mm2 had no effect on MBL were also substantiated by the hematological findings.


A study was undertaken to evaluate the possible influence of the size of the copper surface area in IUDs on menstrual blood loss and to determine if changes in blood loss influence iron stores. Of the 35 healthy women (with a baseline menstrual blood loss of 80 ml) enrolled in the Swedish study, one dropped out. The remaining women randomly received either a Multiload Cu-250 or a Multiload Cu-375 IUD (which is associated with a lower cumulative pregnancy rate). Data on menstrual blood loss, menstrual pattern, possible intermenstrual bleeding, and dysmenorrhea were recorded during a control cycle prior to IUD insertion and for one year thereafter. In each group, an increase in menstrual blood loss was recorded three months after insertion. This increase remained unchanged during the study period and was not significantly different between the two groups. There were no differences in serum ferritin, blood hemoglobin, hematocrit, or erythrocyte indices between the two groups either before IUD insertion or during the study period (during which iron replacement therapy was not permitted). These hematological findings substantiated the conclusion that increasing the copper surface area in the IUD had no effect on menstrual blood loss. The IUDs also had little or no effect on iron status.

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