Analysis on the main complications in LARCS users in primary care

Abstract

Long-term Reversible Contraceptive Methods (LARCS), mainly represented by copper and levonorgestrel intrauterine devices (IUDs) (Mirena and Kyllena),in addition to subcutaneous implant (Implanon),are widely indicated in family planning practice in primary health care, given their high rates of efficacy, safety and adem. However, such characteristicscan be contradicted due to the occurrence of adverse effects, ranging from simple complications to more severe complications, which require other levels of health care for their management. Taking this into account, it became the objective of thisstudy to analyze the incidence of the main complications in LARCS users in primary care according to the percentage of occurrence. For this purpose, descriptive methodology was used, and a literature review was carried out based on articles published on pubmed, scielo and health journals, including The Brazilian Journal of Health Review. Thus, itwas observed that adversities related to the use of IUDs include dysmenorrhea and bleeding (up to 25%) and, less often, ectopic pregnancy (2.9 to 8.9%) and uterine perforation and adjacent structures (up to 1.3%). In addition, pelvic inflammatory disease has also been reported (less than 1%), being more prevalent in cases of cervicitis pre-existing at device insertion. Regarding subcutaneous implants, more moderate alterations such as amenorrhea (39%), acne (16%), weight gain (35%), headache (36%), dizziness (25%) and mastalgia (14%), as well as changes in the gastrointestinal tract (21%). Thus, according to the evidence collected, the superiority of LARCS in relation to the other methods available in the SUS is notorious, with regard to efficacy versus unwanted effects.

Cervically Embedded Fragment of an Intrauterine Device in a Patient with a Bicornuate Uterus: A Case Report and Review of Current Management Strategies

“…The majority of complications follow insertion and are present during IUD use. Of these, dysmenorrhea is the most common complication being seen in up to 25% of individuals, followed by ectopic pregnancy seen in 2.9% to 8.9% of individuals, and uterine perforation is seen in up to 1.3% of individuals [9]. Expulsion can occur between 2% and 10% following insertion in a non-postpartum patient; however, this varies greatly following delivery and by type of delivery [10].…”