Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of an anti-prostaglandin, tolfenamic acid (T.A.), in the prevention of side-effects after insertion of a copper-T200 intrauterine contraceptive device (I.U.D.) was evaluated in a double-blind trial in 160 women. T.A. relieved pain and reduced bleeding after insertion and during three subsequent menstruations without serious side-effects. A scoring system for the assessment of I.U.D. side-effects showed that the acceptability of I.U.D. was significantly better in women treated with T.A. than in those given placebo.
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PMID:Anti-prostglandin therapy in prevention of side-effects of intrauterine contraceptive devices. 7 60

Several methods of intrauterine administration of various progestins have been developed. A low pregnancy rate has been achieved after 12 months of use and the cyclic ovarian function has been maintained. Removal for pain and bleeding has been the same as with the copper T device. A suppression of endometrial growth has been reported and an intense inflammatory reaction has been observed. In this study an intrauterine medicated device containing 38 mg of progesterone which was released at a rate of 65 mcg/day for 1 year was used. Subjects were 9 women, aged 25-30 years, of proven fertility. Endometrial material was obtained on Cycle Days 7-11 and 21-25 in 2 consecutive cycles before insertion of the devices and on the same cycle days in the 2nd-3rd and 6th-7th cycles with the devices in place. 6 of the 9 subjects were fitted with the progesterone device and 3 with a plain T device. Endometrial cell smears were subjected to a fluorometric method for quantitative estimation of DNA per cell nucleus. Only epithelial cells were analyzed. Values were expressed in units of the BAO-fluorescence of 50 cell nuclei per sample. The variation between observation periods was due to a significant decrease in the mean BAO-DNA content per cell nucleus (p less than .01). At 1st, histological examination was normal. However, after 6-7 cycles with the progesterone-releasing IUD in place, an atrophy was observed in the glandular epithelium. Photographic reproductions illustrate the histology observed. Circulating levels of steroids were unchanged indicating normal ovarian function. It is suggested that the progesterone released in utero interfered with the DNA sythesis of the endometrial cells and resulted in a disturbed metabolism preventing implantation.
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PMID:The effect of intrauterine progesterone on the DNA-content in isolated human endometrial cells. 26 27

The Cooperative Statistical Program was initiated in 1963, the 1st effort to evaluate a method of contraception by using pooled data from several clinics and a systematic statistical method. Progress reports were issued from 1963 through 1970. The reports provided epidemiological evidence that Lippes Loop D has the best overall performance of all the IUDs studied. Expulsion, pregnancy, and removal rates for bleeding and pain were measured. Performance rates for all these indices are better with the duration of the device. Since 1970, numbers of new IUDs have been designed and tested clinically. The aim was to improve efficacy, to make IUDs suitable for women who had never been pregnant, and to reduce the incidence of pain and bleeding. The T-shaped IUD has been found to cause lowered rates of removal for pain and bleeding. To counteract the higher pregnancy rate with this device, an antifertility agent can be added to the IUD for timed release. Steroids and copper have both been used. Clinics differ in their performance rates due to differing patient populations, differing physician experience, and differing clinic attitudes. The insertion technique is important to long-term performance.
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PMID:Historical considerations in the development of modern IUD's: patient and device selection and the importance of insertion techniques. 34 70

5 cases of IUD perforation of the cervix were encountered during a 5-year period (1973-78). In these cases, the distal end of the stem (vertical limb) of the T had penetrated through the cervical wall into 1 of the fornices of the vagina. Case 3 involves a 31-year old gravida 3, para 1 who presented at the Hasharon Hospital in the 10th week of pregnancy complaining of lower abdominal pain and mild bleeding. Her physician had previously recommended removal of IUD upon finding out of her pregnancy, but she had refused because the IUD removal "might harm the pregnancy". The present examination revealed cervical perforation by the copper T-IUD, which was then removed through the tiny fistula in the cervix. Bleeding and pain disappeared within 3 days. The woman delivered a normal healthy baby 29 weeks later. Case 4 concerns a 24-year old gravida 3, para 2 who presented at the clinic at the 12-monthly check-up. The string of the IUD was found protruding through the cervical os, while the copper-covered long arm of the IUD had perforated the cervix and was felt in the posterior fornix. The fistula disappeared after the IUD was removed. Although cervical perforations rarely consititute a risk to the woman and are easily removed without permanent damage to the cervix, such complications if they do occur should be reported in view of their extensive use world wide. In addition, risk of pregnancy is increased due to the displacement of the device.
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PMID:Secondary cervical perforation by the Copper-T intrauterine device. 40 Aug 70

A sequential study analyzed 1792 women randomly using 3 different Copper T IUDs. The TCu 220C with a 30 sq. mm. sleeve on each horizontal sleeve and 5 sleeves on the vertical arm was inserted in 903 women. The TCu 380A with a copper sleeve on each horizontal arm and wound copper on the vertical arm was inserted in 391 women, while 498 women used the wound copper wire TCu 300. The TCu 380A produced the lowest pregnancy rate, but the difference in pregnancy rates for the 3 devices was not statistically significant. The TCu 300 had the lowest cumulative termination rate for expulsion, pain, and bleeding, but it was not significantly lower than the other 2 IUDs by 3 years after insertion. Since the horizontal and vertical sleeves of the TCu 220C are less flexible it is possible they produce a downward displacement with uterine contractions resulting in increased bleeding and pain. It may also account for the increased pregnancy rate and rate of removal of the TCu 220C. Other long-term, large-scale evaluations should be made to confirm that the TCu 380A, with an 8-year lifespan, has the low pregnancy and removal rates found in this study.
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PMID:Comparison of three different models of the copper T intrauterine contraceptive device. 45 97

Postabortion insertion of IUDs decreases high postabortion contraceptive dropout rate; offers immediate protection; and lessens the difficulty, pain and lack of patient's cooperation associated with later IUD insertion. 162 pregnant teenagers of low intelligence and/or low motivation from low income families were offered immediate postabortion IUD insertion following curettage for artificial abortion. The insertions were done while the patients were still under general anesthesia (112 patients) or paracervical block anesthesia (35 patients). No complications were observed during the procedure. During the 1st 12 months of use, a significant difference in the occurrence of some complications (expulsions, uterine bleeding and removal of IUD for medical reasons such as bleeding/pain) was observed between the Lippes loop group and the 2 copper (Cu 7 and Cu T) groups. Almost all patients had menorrhagia and metrorrhagia during the 1st 6 to 8 weeks postinsertion; the bleeding subsided thereafter. 15 (92%) of the patients had IUD removal for medical reasons (bleeding irregularities; dysmenorrhea; adnexal tenderness). Expulsion occurred in 18 patients: 11 had Lippes loop; 3 Cu 7, and 4 Cu T. 6 became pregnant with the IUD in situ; insertion-pregnancy intervals ranged from 6 months to 12 months. Total continuation rate for 12 months was 69.1%. Although this study is limited in that it is short-term (1 year) and has ar elatively small sample size, it shows that postabortion IUD insertion provides 1) ease of insertion; 2) no serious complications; 3) few side effects, and 4) an acceptable low expulsion rate, especially with copper IUDs.
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PMID:Immediate postabortion intrauterine contraception in nulliparous adolescents. 45 86

A young patient, a wearer of a copper IUD for about 18 months, was hospitalized for bleeding and severe pain. Several tests were performed and a diagnosis of tubal pregnancy made. The patient underwent surgery for rupture of the left oviduct. Presence of corpus luteum was found in the right ovary. It is possible that the presence of the copper IUD helped in the formation of substances similar to prostaglandins, which caused peristaltic contractions in the left oviduct.
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PMID:[A case of tubal pregnancy caused by an intrauterine contraceptive device]. 46 Jun 77

Long-term observation of the use-effectiveness and safety of 745 Copper-IUD's has demonstrated: 1) The pregnancy rate decreases distinctly after 2 years; until now no pregnancy has been observed after 4 years continuous use. 2) The endometrium responds first with an inflammatory reaction, later it shows signs of deficient secretion, but after a longer period seems to become normal again. 3) Contamination of IUD's begins early, mostly with bacteria of vaginal origin, later the number of sterile IUD's increases. -- A septic abortion after pregnancy with an IUD in situ has not occurred amongst our cases. 4) The rate of copper elution continues steadily, but in spite of demonstrable corrosion there is no obse-vable decrease of contraceptive effectiveness. Copper-IUD's can remain as long as 5 years in situ, if no untoward side effects (pain, bleeding, infection) occur. It may be advisable to remove them after that period as corrosion may affect devices at present commercially available.
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PMID:[Long-term observations on use-effectiveness of copper-IUD's (author's transl)]. 52 Jul 74

A study was conducted at the Family Planning Centre of the Hospital Jose Joaquin Aguirre, Chile, involving 146 patients who had a Progestasert TM IUD inserted and 149 patients who had a Copper 7 IUD, Gravigard TM, inserted to determine the occurrence of dysmenorrhea. All patients completed questionnaires concerning habitual pelvic or genital pain prior to IUD insertion as well as at 1, 3, 6, and 12 months after insertion. Results indicated a reduction in menstrual cramps over 12 months of use. The Progestasert TM group showed a slightly higher reduction of menstrual cramps than Copper 7 users; however, the reductions are not significant. There were no significant differences between premenstrual and intermenstrual cramps. With the use of a questionnaire and the subjective condition of pain, it is difficult to ascertain whether the IUD produced any change in menstrual cramps or whether the reduction of pain originated in the patients; therefore, the technique of questioning the occurrence of pain may not be reliable enough.
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PMID:A comparative study of the effect of the Progestasert TM and Gravigard IUDs on dysmenorrhoea. 52 41

A clinical study of 335 Copper T insertions and 255 loop insertions was conducted at the J.L.N. Hospital, Ajmer from November 1974 to April 1976. Patients were followed up for 1 1/2 years. It was found that more complications of pain, bleeding, and backache occurred with loop insertions. Complications from the Copper T usually resulted when the insertion occurred after a medically terminated pregnancy (MTP). 140 Copper Ts were inserted at the postnatal clinic usually on the 6th day after delivery; in 115 cases it was inserted after MTP, and in 80 cases 1 1/2 months after delivery. The loops were inserted at any time 1 1/2 months after delivery: 88 were inserted in postnatal cases and 115 in cases after MTP. Incidence of abdomen pain with Copper T was 1.2% in postnatal clinic cases; .9% after postnatal period; 1.5% in MTP cases. For the loop the percentages were 1.9, 1, and 2 respectively. The failure rates were higher with the Copper T which is smaller than the loop and covers less of the endometrium.
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PMID:Comparative study of copper T and loop insertion. 54 3


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