title: Therapeutic Options for Unscheduled Bleeding Associated with Long-Acting Reversible Contraception.
abstract: Long-acting reversible contraception (LARC) is the most effective form of reversible contraception. Although most women are satisfied with LARC methods, unscheduled bleeding and spotting are common reasons for method dissatisfaction and discontinuation. This systematic analysis of the current literature delineates treatment options for unscheduled bleeding related to LARC use. Although consistent results are lacking, all devices seem to have the best response to nonsteroidal antiinflammatory drugs for 5 to 7 days or the antifibrinolytic agent tranexamic acid. Additional studies are necessary to identify improved treatment interventions for unscheduled bleeding with LARC use.
authors.affiliation: Family Planning Division, Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, #824, Honolulu, HI 96826, USA. Electronic address: emmakate@hawaii.edu.
authors.forename: EmmaKate
authors.initials: E
authors.lastname: Friedlander
authors.affiliation: Family Planning Division, Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, #824, Honolulu, HI 96826, USA.
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D003267:Contraception / Q000009:adverse effects*; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel; D061965:Matrix Metalloproteinase Inhibitors / Q000627:therapeutic use; D015735:Mifepristone / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000933:Antifibrinolytic Agents; D006727:Hormone Antagonists; D061965:Matrix Metalloproteinase Inhibitors; D015735:Mifepristone; D016912:Levonorgestrel; D014148:Tranexamic Acid; D004318:Doxycycline
keywords: Contraceptive implant; Etonogestrel; Intrauterine device; Irregular bleeding; Levonorgestrel