Gynecology and Obstetrics

Medicated Intrauterine Devices

Intrauterine device (IUD) is a small, flexible plastic frame to be inserted into the uterine cavity. It mainly work by changing the intra-uterine environment and making it spermicidal. Non-medicated IUD cause a sterile inflammatory response by producing a tissue injury of minor degree but enough to be spermicidal. Hormone releasing IUD add progesterone effect on endometrium to the foreign body reaction. The endometrium becomes decidualized with atrophy of glands. The progesterone IUD does not increase the serum progesterone level and mainly acts by inhibition of implantation, sperm-capacitation and survival. Levonorgestrel IUD produces serum concentrations of the progestin half those of Norplant and therefore, ovarian follicular development and ovulation is not inhibited. The LNG-20 IUD decreases the blood loss (by about 40-50%) and dysmenorrhea.