Teens Can Control the Major Cramps

Endometriosis pain and bleeding suppressed in teenagers with IUD usage

(RxWiki News) Cramps are completely normal during a teenage girl's period. Severe cramps that occur at other times of the month could mean a more serious condition that needs treatment.

A new study showed that teenage girls who have endometriosis, in which the lining of the uterus grows into other parts of the body, had less pain and bleeding after using a certain intrauterine device (IUD).

According to the researchers, the findings showed that IUDs that release levonorgestrel, a female hormone, can treat endometriosis in teenagers. 

"Talk to your OB/GYN about treatment for pelvic pain."

The aim of the study, led by Jennie Yoost, MD, from the Kosair Children's Hospital in Louisville, Kentucky, was to see how certain intrauterine devices (IUD) affected abdominal pain and bleeding in adolescent girls with endometriosis.

Researchers also aimed to see whether inserting the IUD during surgery to diagnose the condition made a difference in pain and bleeding versus inserting the IUD later on.

In endometriosis, the lining of the uterus grows out into other areas of the body. An IUD is a T-shaped method of birth control that is inserted into a woman's uterus and changed out after several years.

The study included 17 girls ranging from 14 to 22 years of age who were treated at the Pediatric Adolescent Gynecology Clinic and Children's Hospital from October 2009 to June 2011.

All the girls had chronic pain in their abdomen and underwent laparoscopy to be diagnosed. During this procedure, a tube with a camera on the end is inserted into a small cut made in the belly.

Upon being diagnosed with endometriosis, participants were given Mirena – a levonorgestrel intrauterine system (LNG-IUS). The hormone causes changes in the lining of the uterus and mucus in the cervix.

While Mirena does not carry the side effect risks that come with other methods of birth control, the IUD may lead to breakthrough bleeding, absence of periods, weight gain and mood changes. More serious side effects include uterine inflammation, pelvic infection and perforation of the uterus.

Half of the patients received the IUD as they were diagnosed during surgery. The rest were given the IUD after surgery was completed. 

After receiving the IUD, researchers assessed patients' pain and bleeding levels during follow-up appointments.

Pain was classified as either none, minimal, moderate or severe. Categories for bleeding consisted of none, irregular spotting, irregular bleeding or bleeding daily.

Patients who were given IUDs after surgery stopped bleeding less than two and a half months later with pain suppressed after another two months, researchers found. 

Girls who received the IUD during surgery had suppressed pain and bleeding a little more than four months and five months later. The difference between the two groups was not significant.

In addition, researchers found that two-thirds of patients needed additional hormonal therapy for their abdominal pain and to stop the bleeding.

"Our study, while retrospective, sheds insight that the LNG-IUS is indeed effective at diminishing pain and bleeding associated with endometriosis in adolescent patients," researchers wrote in their report.

The researchers noted that they did not use a standardized system when measuring patients' pain. Future research should address how the IUDs affect endometriosis in adolescents over a longer period of time.

The study, which did not receive any funding, was published in the April issue of the Journal of Pediatric and Adolescent Gynecology. No conflicts of interest were reported.

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Review Date: 
March 27, 2013