title: Can intrauterine contraceptive devices lead to VulvoVaginal Candidiasis (VVC) and Anemia in Iranian new users?
abstract: OBJECTIVE
  To assess the prevalence of anemia and VulvoVaginal Candidiasis (VVC) in women before and 3 months after copper Intra Uterine Device (IUD) insertion.
  
  
  METHODS
  Longitudinal prospective study was performed with 101 women aged 15-45 year who wanted to use the IUD at six health centers in Tehran, Iran from November 2011 to August 2012. The pattern of bleeding, Hemoglobin and Hematocirt levels, and Candida colony count/cultures in the women were assessed before and after 3 months of IUD insertion. Data analysis was performed by descriptive and analytical statistics using the SPSS software for Windows.
  
  
  RESULTS
  At the end of 3 months, a significant increase in menstrual blood loss and a significant decrease of Hb and HCT (P=0.047 and 0.001, respectively) were reported. Moreover, no difference in the prevalence of anemia before and after IUD insertion was observed. The mean±SD Candida colony counts significantly increased (P=0.001), but positive Candida cultures were not significantly different before and 3 months after IUD insertion. Also, no clinical VVC was reported 3 months after IUD insertion. While BMI≥29 had a positive relationship with Candida colony counts, the results remained unchanged after adjusting for potential risk factors.
  
  
  CONCLUSIONS
  Despite an increase in bleeding and Candida colony counts in copper IUD users in this study, clinical VVC or anemia cases were not increased, which indicates relative safety of this contraception method. The study findings can be helpful to healthcare professionals and midwives to counsel women who want to start using IUD and also current users who are contemplating IUD removal due to its complications.
authors: Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Samira
authors: S
authors: Behboudi-Gandevani
authors: Midwifery and Reproductive Health Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors: Somaieh
authors: S
authors: Imani
authors: Midwifery and Reproductive Health Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Electronic address: moghaddamb@modares.ac.ir.
authors: Lida
authors: L
authors: Moghaddam-Banaem
authors: Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors: Shahla
authors: S
authors: Roudbar-Mohammadi
mesh_terms: D000293:Adolescent; D000328:Adult; D000743:Anemia, Hemolytic / Q000175:diagnosis* / Q000209:etiology*; D002175:Candida / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000382:microbiology*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects* / Q000706:statistics & numerical data; D007492:Iran / Q000453:epidemiology; D008137:Longitudinal Studies; D008598:Menstruation / Q000187:drug effects; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014621:Vagina / Q000382:microbiology; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D006454:Hemoglobins
keywords: Anemia; Candida; Copper IUD