[Intrauterine contraception in women over 35-years old: comparison between copper and progesterone IUDs].

Lately physicians have become more cautious about dispensing oral contraceptives to their patients aged 35 and older. Therefore there has been a increase in IUD prescriptions for this age group. Research has also increased to determine which IUD is most effective and which causes fewer side effects. An Italian survey comparing copper and progesterone IUDs provides some of the necessary facts. The survey was conducted on 100 women ages 35 and over (50 with the progesterone and 50 with the copper). Many had previously used IUDs and most had already had children. The doctors expected to find some alterations in the rhythm of the menstrual cycle but found no significant variations. There was however a notable difference in the duration of and in the amount of blood flow during the menstrual cycle. Although apparently augmented in both groups with copper IUDs the flow seems to be more abundant but the prolongation is less while with the progesterone the duration seems to be prolonged but blood flow is limited. The few episodes that could be described as hemorrhage were found in progesterone users who complained with greater frequency of white cell loss. The 1st finding was that 86% of the women studied with the copper IUD were able to complete the designated term while only 76% were able to with progesterone IUDs. Of the 3 pregnancies which did occur (1 of them was ectopic) all were from progesterone IUD users. Hemorrhaging played a role in early removal in some progesterone users and the reduction in the flow quantity caused a tolerance problem in some cases. The only real drawback to the copper IUD is that it causes more pelvic back pain cases. There are no valid reasons indicated for preferring the progesterone IUD. Overall 96% of the copper IUD users were satisfied while only 70% of those with the progesterone IUDs were satisfied.