铜宫内节育器的副作用：其副作用会随着时间推移而减少吗？
Side effects from the copper IUD: do they decrease over time?
作者信息
Hubacher David, Chen Pai-Lien, Park Sola
机构信息
Family Health International, Research Triangle Park, NC 27709, USA.
出版信息
Contraception. 2009 May;79(5):356-62. doi: 10.1016/j.contraception.2008.11.012.
BACKGROUND
The copper intrauterine device (IUD) can cause side effects in some women; increased uterine bleeding and pain may cause early removal. Because of simplified reporting from previous research, little is known about how side effects might change over time.
STUDY DESIGN
This is a secondary analysis of a prospective study of 1947 first-time copper IUD users. Over a 1-year period, we collected detailed information on side effects and looked for trends using generalized mixed-effects regression modeling.
RESULTS
During menses, most bleeding and pain side effects were found to decrease over time (p<.05). During intermenstrual intervals, overall spotting and pain complaints remained unchanged, but the number of days with these problems increased (p<.05). Serious side effects that prompted either a clinic visit or IUD removal had varied patterns over time, depending on the type of problem.
CONCLUSION
Side effects from the copper IUD can be troubling for both user and clinician. Some problems improve over time, while others do not. This information may be helpful in counseling women who are considering IUD use and current users who are contemplating IUD removal due to side effects.
背景
铜宫内节育器（IUD）可能会在一些女性身上引起副作用；子宫出血和疼痛加剧可能导致过早取出。由于以往研究的报告较为简略，对于副作用如何随时间变化知之甚少。
研究设计
这是一项对1947名首次使用铜IUD的前瞻性研究的二次分析。在一年的时间里，我们收集了关于副作用的详细信息，并使用广义混合效应回归模型寻找趋势。
结果
在月经期间，大多数出血和疼痛副作用随时间推移而减少（p<0.05）。在月经间期，总体点滴出血和疼痛主诉保持不变，但出现这些问题的天数增加（p<0.05）。导致就诊或取出IUD的严重副作用随时间呈现不同模式，这取决于问题的类型。
结论
铜IUD的副作用对使用者和临床医生来说都可能令人困扰。一些问题会随时间改善，而另一些则不会。这些信息可能有助于为考虑使用IUD的女性以及因副作用而考虑取出IUD的现有使用者提供咨询。
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