IUDs May Keep the Pain Away

Surgery to treat the pain caused by endometriosis is often effective, but it doesn't guarantee that the pain won't return. A method of birth control could help prevent pain from coming back.

Using an intrauterine device (IUD) after surgery for endometriosis reduced the recurrence of painful menstrual periods.

The T-shaped IUD is inserted into a woman's uterus for long-term birth control.

These findings suggest that IUDs may also provide a way for women with severe abdominal pain to reduce their symptoms and keep the pain from returning.

Bad cramping? Ask a doctor about IUDs.

In endometriosis, the lining of a woman's uterus grows outward into other areas of the body. It can cause severe pain and swelling in the abdomen, which could lead to surgery in more serious cases.

The aim of the study, led by Ahmed Abou-Setta, PhD, research associate at the Centre for Healthcare Innovation at the University of Manitoba in Canada, was to see whether inserting an IUD in a woman with endometriosis would reduce abdominal pain and other symptoms compared to therapy after having surgery.

Researchers looked through three previous studies involving 135 women who had surgery for endometriosis.

After surgery, participants received one of the following: an IUD, GnRH analogue (a medicine designed to release hormones that regulate a woman's menstrual cycle) or no treatment at all.

Though fewer women in the IUD group had painful periods compared to the other groups, the differences were minimal, researchers found.

Two of the studies found no differences between the groups concerning pain levels and quality of life. A third study found that women with the IUD had a 22 percent lower chance of having painful periods compared to the other groups.

More women in the IUD group were satisfied with their treatment, though the differences compared to the other groups were small.

Further, more women in the IUD group reported that their periods had changed compared to the other test groups.

"It is not clear whether patient compliance over a prolonged period might affect the overall results," researchers wrote in their report.

"Even so, the consistent results presented by the trials regarding the decreased incidence of recurrence of painful periods is encouraging."

The authors noted that the included studies were small, which might have caused the results to be biased. However, studies that were not included in the review had similar results.

According to the authors, future research should follow up with endometriosis patients who use IUDs over a longer period of time to investigate whether cases have returned or if further surgery is needed.

The study was published January 31 in The Cochrane Library, under the Cochrane Collaboration. The study did not receive any funding and no conflicts of interest were reported.