Guillebaud J, Bonnar J
Br J Obstet Gynaecol. 1978 Sep;85(9):707-12. doi: 10.1111/j.1471-0528.1978.tb14951.x.
A randomized serial study of uterine blood loss was made of 281 women fitted with one of three intrauterine contraceptive devices (IUCDs): a Lippes loop D, a Dalkon shield or a Copper 7. The increase in the amount of blood loss was greatest with Lippes loop D users and least with Copper 7 users. However, the duration of menstrual and intermenstrual bleeding and of spotting was significantly greater among Copper 7 users than with the two inert devices. Thus the mechanisms whereby IUCDs increase the duration as opposed to the volume of uterine bleeding may be different. Previous users of oral contraceptives were found to have significantly less bleeding before IUCD insertion, but showed a similar pattern of increase of uterine bleeding after IUCD insertion to those who had not used oral contraceptives. For all three IUCDs, the increment in amount and duration of uterine bleeding after insertion decreased between the first and the sixth period, on average by about 15 ml and one to two days. No subsequent improvement was found and after 12 cycles the Copper 7 users had longer but less heavy uterine blood loss than users of the Lippes loop D.
对281名使用三种宫内节育器(IUCD)之一的女性进行了一项关于子宫失血量的随机系列研究:利普斯D形环、达康盾或铜7型。使用利普斯D形环的女性失血量增加最多,而使用铜7型的女性失血量增加最少。然而,铜7型使用者的经期、经间期出血和点滴出血持续时间明显长于使用两种惰性节育器的女性。因此,宫内节育器增加子宫出血持续时间而非出血量的机制可能不同。研究发现,以前使用口服避孕药的女性在插入宫内节育器前出血明显较少,但插入宫内节育器后子宫出血增加模式与未使用口服避孕药的女性相似。对于所有三种宫内节育器,插入后子宫出血量和持续时间的增加在第一个周期和第六个周期之间减少,平均减少约15毫升和一至两天。未发现后续改善,在12个周期后,使用铜7型的女性子宫失血量持续时间较长但出血量较少,低于使用利普斯D形环的女性。