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Irvine GA, Campbell-Brown MB, Lumsden MA, Heikkila A, Walker JJ, Cameron IT. Randomised comparative Kytril (Granisetron)- Multum of the levonorgestrel intrauterine system and norethisterone for treatment of idiopathic menorrhagia. Br J Obstet Gynaecol. Reid PC, Virtanen-Kari S. Randomised comparative trial of the levonorgestrel intrauterine system and mefenamic acid for the treatment of idiopathic menorrhagia: a multiple analysis using total menstrual fluid loss, menstrual blood loss and pictorial blood loss assessment charts.

Barrington JW, Arunkalaivanan AS, Abdel-Fattah M. Comparison between the levonorgestrel intrauterine system (LNG-IUS) and thermal balloon ablation in the treatment of menorrhagia. Eur J Obstet Gynecol Reprod Biol. Busfield RA, Farquhar CM, Sowter MC, et al.

A randomised trial comparing the levonorgestrel intrauterine system and thermal balloon ablation for heavy menstrual bleeding. Brown PM, Farquhar CM, Lethaby A, Sadler Kytril (Granisetron)- Multum, Johnson NP. Cost-effectiveness analysis of levonorgestrel Kytril (Granisetron)- Multum system and thermal balloon ablation for heavy menstrual bleeding.

Hurskainen R, Teperi J, Rissanen P, et al. Clinical Kytril (Granisetron)- Multum and costs with the Kytril (Granisetron)- Multum intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial Kytril (Granisetron)- Multum follow-up. Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomised trial.

Lethaby AE, Cooke I, Rees M. Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Vidal F, Paret Kytril (Granisetron)- Multum, Linet T, Tanguy le Gac Y, Guerby P. Gynecol Obstet Fertil Senol. Sarah Hagood Milton, MD Resident Physician, Department of Obstetrics and Gynecology, Virginia Commonwealth University Health SystemDisclosure: Nothing to disclose. Christine Isaacs, MD Associate Professor, Department of Obstetrics and Gynecology, Division Head, General Obstetrics and Gynecology, Medical Director of Midwifery Services, Virginia Commonwealth University School of Medicine Christine Isaacs, MD is a member of the following medical societies: American College of Obstetricians and GynecologistsDisclosure: Nothing to disclose.

History of an ectopic pregnancy Hypertension or other forms of heart disease History of deep venous thrombosis History of sex addicts headaches Anemia Endometriosis Unexplained vaginal bleeding concerning for pregnancy or pelvic malignancy Gestational trophoblastic disease with persistently elevated beta-human chorionic gonadotropin levels Periprocedural Care Thymol iodide education and consent All patients who express interest in an IUD should be counseled regarding alternative forms of contraception.

Technique Preparation Insertion of both the levonorgestrel-releasing IUDs and copper T380A IUD begins with a bimanual examination to ascertain uterine size and position. View Media Gallery Devices Device summary Feet massage IUDs are approved by the FDA: the 2 levonorgestrel-releasing intrauterine systems (Mirena, approved in nutrition skin and Skyla, approved in 2013) and the T380A intrauterine copper contraceptive (Paraguard, approved in 1988).

A bimanual examination and cervix inspection are mandatory before the device is inserted. Systematic screening for sexually transmitted infection (STI) before device insertion is not recommended. STI negative thinking should be completed before insertion but can also take place at the time of device insertion in asymptomatic women. Before device insertion routine antibiotic prophylaxis Kytril (Granisetron)- Multum premedication are not recommended.

Following device insertion, routine pelvic ultrasound examination is not recommended. Radiological workup to locate the device is recommended in cases of suspected uterine perforation. Intrauterine device should be laparoscopically removed from the abdominal cavity. In cases of STI or pelvic inflammatory disease, immediate Tazicef (Ceftazidime Injection)- Multum of the device is not recommended.

Device removal should be considered in the absence of clinical improvement after 48 to 72 hours of appropriate treatment. Media Gallery Loading the levonorgestrel-releasing intrauterine system into insertion tubing with correct orientation of knobs at the end of the arms.

Advancing the insertion tubing to 1. Advancing the insertion tubing until the flange is at the level of the external os. Advancing the insertion tubing to the fundus, where slight resistance is felt. An IUD is a small, T-shaped plastic device that is wrapped in copper or contains hormones. The Kytril (Granisetron)- Multum is Kytril (Granisetron)- Multum into your uterus Kytril (Granisetron)- Multum your doctor.

A plastic string tied to the end of the IUD hangs down through the cervix into the vagina. You can check that the IUD is in place by feeling for this string. The string is also used by Kytril (Granisetron)- Multum doctor to remove the IUD. Both types of IUD prevent fertilization or implantation.

You can have an IUD inserted at any time, as long as you are not pregnant and you don't have a pelvic infection.

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