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Insertional pain and other IUD insertion-related rare events for breastfeeding and non-breastfeeding women — a decade's experience in developing countries

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Advances in Contraception

Abstract

The possible effect of breastfeeding on intrauterine device (IUD) insertion events was investigated. Analysis included a total of 6493 women who enrolled in multicenter IUD clinical trials over a ten-year period. Findings indicate that breastfeeding exerts a protective effect on the incidence of moderate to severe insertional pain and reduces the need for cervical dilatation to facilitate insertion. The pain protection effect was most evident in breastfeeding women who were still in lactational amenorrhea. Subjects with amenorrhea, both breastfeeding and non-breastfeeding, had a significantly lower incidence of pain at IUD insertion than the corresponding menstruating subjects. This effect may be related to a higher secretion of beta-endorphin in the breastfeeding and lactational amenorrheic subjects.

Resumé

Cette étude présente les effets possibles de l'allaitement au sein sur des phénomènes liés à l'insertion de dispositifs intra-utérins (DIU). La recherche portait 6493 femmes inscrites dans plusieurs centres pour participer à des essais cliniques pendant une période de dix ans. On a constaté que l'allaitement au sein a un effet protecteur contre l'apparition de douleurs modérées à fortes au moment de l'insertion et qu'il réduit la nécessité de dilater le col utérin en vue de faciliter l'insertion. Cet effet de protection contre les douleurs prédominait chez les femmes qui allaitaient et se trouvaient encore en aménorrhéc de lactation. Les douleurs au moment de l'insertion étaient significativement moins fréquentes au moment de la pose du DIU chez celles qui, allaitant ou non, étaient encore en période d'aménorrhée, que chez celles dont le cycle menstruel avait repris. Cet effet peut être lié à une sécrétion plus abondante de β-endorphine chez les femmes en période d'allaitement ou d'aménorrhée de lactation.

Resumen

Se investigaron en este estudio los posibles efectos del amamantamiento sobre la inserción de dispositivos intrauterinos (DIU). El estudio comprendió 6493 mujeres que participaron en ensayos clínicos en diversos centros durante un período de diez años. Los resultados indican que el amamantamiento ejerce un efecto protector contra la aparición de dolores moderados a fuertes en el momento de la inserción y reduce la necesidad de dilatar el cuello del útero para facilitar la inserción. Este efecto de protección contra el dolor predominó entre las mujeres que amamantaban y se hallaban aún en amenorrea de lactación. Las mujeres con amenorrea, tanto las que amamantaban como las que no lo hacían, señalaron un nivel de dolor significativamente menor en el momento de inserción del DIU que aquéllas cuyo ciclo menstrual se había reanudado. Este efecto puede estar relacionado con una mayor secreción de β-endorfina en las mujeres en período de amamantamiento o de amenorrea de lactación.

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References

  1. McCannM.F., LiskinL.S., PiotrowP.T., RinchartW. and FoxG. (1984). Breastfeeding, fertility and family planning.Popul. Rep., (J)24, 527–567

    Google Scholar 

  2. HingoraniV. and Uma BaiG.K. (1970). Lactation and lactational amenorrhoca with postpartum IUCD insertion.Reprod. Fertil.,23, 513–515

    Google Scholar 

  3. HefnawiF., DannoilO., BadraouiM.H.H. et al. (1975). Effect of inert IUDs on lactation. In:Analysis of Intrauterine Contraception. F.Hefnawi and S.Segal, eds., North Holland Publishing Company, amsterdam, pp. 431–438

    Google Scholar 

  4. PremaK. (1982). Duration of lactation and return of menstruation in lactating women using hormonal contraception and IUDs.Contracept. Deliv. Syst.,3, 39–46

    PubMed  Google Scholar 

  5. ColeL.P., McCannM.F., HigginsJ.E. and WaszakC.S. (1983). Effects of breast-feeding on IUD performance.Am. J. Pub. Health,73, 384–388

    PubMed  Google Scholar 

  6. ChiI-c., WilkensL. and RogersS. (1985). Expulsion in immediate post-partum insertion of Lippes Loop D and Copper T IUDs and their counterpart Delta devices-an epidemiological analysis.Contraception,32, 119–134

    PubMed  Google Scholar 

  7. World Health Organization (WHO) (1987).Mechanism of Action, Safety and Efficacy of Intrauterine Devices, Geneva, WHO, (Technical Report Series 753), 1–91

    Google Scholar 

  8. HeartwellS.F. and SchiesselmanS. (1983). Risk of uterine perforation among users of intrauterine devices.Obstet. Gynecol.,61, 31–36

    PubMed  Google Scholar 

  9. ChiI-c., GalichL.F. and TauberP.F., et al. (1986). Severe pain at interval IUD insertion-A case-control analysis of patient risk factors.Contraception,34, 483–495

    PubMed  Google Scholar 

  10. ChiI-c., ChampionC.B. and WilkensL.R. (1987). Dilatation of cervix in interval insertions of the IUD-Who requires it and does it lead to a high expulsion rate?Contraception,36, 403–415

    PubMed  Google Scholar 

  11. ChiI-c. and RogersS. (1983). Failure to insert an intrauterine device.Contracept. Deliv. Syst.,4, 207–211

    PubMed  Google Scholar 

  12. ChiI-c., WilkensL., SiemensA.J. and LippesJ. (1986). Syncope and other vasovagal reactions at interval insertion of Lippes Loop D.Contraception,33, 179–187

    PubMed  Google Scholar 

  13. ChiI-c., FelbdlumP.J. and RogersS.M. (1984). IUD-related uterine perforations-An epidemiologic analysis of a rare event using an international dataset.Contracept. Deliv. Syst.,5, 123–130

    PubMed  Google Scholar 

  14. RatnamS.S. and TowS.H. (1970). Translocation of the loop. In:Postpartum Family Planning: A Report on the International Program. G.Zatuchni, ed., McGraw-Hill, New York, pp. 371–384

    Google Scholar 

  15. Liskin, L.S. and Fox. G. (1982). IUDs: An appropriate contraceptive for many women.Popul. Rep., (B) 103–135

  16. SivinI. (1985). Recent studies of more effective Copper T devices. In:Intrauterine Contraception, Advances and Future Prospects. G.I.Zatuchni, A.Goldsmith and J.J.Sciarra, eds., Harper and Row, Hagerstown, pp. 70–78

    Google Scholar 

  17. SackettD.L. (1979), Bias in analytic research. In:The Case-control Study-Consensus and Controversy. M.A.Ibrahim, ed., Pergamon Press, Oxford, pp. 51–63

    Google Scholar 

  18. ChiI-c., WilkensL., SiemensA.J. and PottsM. (1987). Rare events occurring at insertion of an intrauterine device-A review of an international experience.Adv. Contracept.,3, 49–61

    PubMed  Google Scholar 

  19. KleinbaumD.G., KupperL.L. and MorgensternH. (1982),Epidemiologic Research, Lifetime Learning Publications, Belmont, California, 447

    Google Scholar 

  20. GoldstuckN.D. (1988). IUD insetion forces: effect of recent childbirth and lactation.Adv. contracept.,4, 159–164

    PubMed  Google Scholar 

  21. GoldstuckN.D. (1987). ‘Bowing’ forces with IUD insertions in vitro: Relevance to different IUD insertions.Clin. Reprod. Fertil.,5, 173–176

    PubMed  Google Scholar 

  22. GordonK., RenfreeM.B., ShortR.V. and ClarkeI.J. (1987). Hypothalamo-pituitary portal blood concentrations of β-endorphin during suckling in the ewe.J. Reprod. Fertil.,79, 397–408

    PubMed  Google Scholar 

  23. RiskindP.N., MillardW.J. and MartinJ.B. (1984). Evidence that thyrotropin-releasing hormone is not a major prolactin-releasing factor during suckling in the rat.Endocrinology,115, 312–316

    PubMed  Google Scholar 

  24. LohH.H. and LiCh.H. (1977). Biological activities of β-endorphin and its related peptides.Ann. NY Acad. Sci.,297, 115–130

    PubMed  Google Scholar 

  25. HatcherR.A., GuestF., StewartF. et al. (1986).Contraceptive Technology, 1986–1987. 13th edn. Irvington Publishers, New York, 85

    Google Scholar 

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Authors and Affiliations

  1. Research Triangle Park Branch, Family Health International, PO Box 13950, 27709, Durham, North Carolina, USA

    I. C. Chi, L. R. Wilkens, C. B. Champion, R. E. Machemer & R. Rivera

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  1. I. C. Chi
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  2. L. R. Wilkens
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  3. C. B. Champion
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  4. R. E. Machemer
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  5. R. Rivera
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Chi, I.C., Wilkens, L.R., Champion, C.B. et al. Insertional pain and other IUD insertion-related rare events for breastfeeding and non-breastfeeding women — a decade's experience in developing countries. Adv Contracept 5, 101–119 (1989). https://doi.org/10.1007/BF01849478

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  • DOI: https://doi.org/10.1007/BF01849478

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