In general, the placement of an IUD can cause abnormal menstruation, with increased menstrual flow and changes in menstrual patterns being the most common. The occurrence of amenorrhea is rare and is mostly caused by progesterone-containing IUDs.
Amenorrhea is a symptom common to many gynecological conditions and is not the name of a disease. Anyone who has reached 18 years of age and has not yet had a menstrual period is called primary amenorrhea; anyone who has previously established a menstrual cycle and now has a non-physiological menopause of three months or more is called secondary amenorrhea. (1) uterine amenorrhea, such as congenital absence of uterus or uterine dysplasia, endometrial damage or hysterectomy, endometrial dysplasia; (2) ovarian amenorrhea, such as congenital absence of ovaries or ovarian dysplasia, ovarian damage or excision, ovarian tumor, premature ovarian failure; (3) pituitary amenorrhea, such as pituitary damage, pituitary tumor, primary pituitary (4) subthalamic amenorrhea, such as psychoneurological factors, wasting diseases, obesity reproductive dystrophy, drug suppression syndrome; (5) other causes or endocrine function abnormalities, such as hyperfunction or deficiency of the thyroid gland, adrenal glands, certain drugs such as anti-hypertension, drugs used to suppress mental disorders, etc.
For amenorrhea, we must first distinguish whether it is physiological or pathological amenorrhea. Physiological amenorrhea would include pregnancy, during pregnancy for sure one does not get a period, and also during breastfeeding. If it is not one of these states, then it is pathological amenorrhea. In pathological amenorrhea, we need to understand whether there is a problem in the reproductive tract, in the ovaries, or in a higher level, in the pituitary hypothalamus.
Through several experiments, that is, progesterone withdrawal experiments. A person has been amenorrheic for a long time without a period, and after a few shots of progesterone, see if a period can come. If it comes, it means that the reproductive tract is open and the person has estrogen itself. If the person does not get a period after progesterone, then we will find out whether there is no estrogen or the reproductive tract itself is not open. If the estrogen and progesterone test results in menstruation, it means that the person’s reproductive tract is open, but there is no estrogen, which is the reason for not having menstruation. The hormone level must be taken before the start of the medication, that is, before the progesterone and progesterone withdrawal test, to check the hormones in the blood, that is, after the progesterone test, no menstruation, and the estrogen and progesterone test can bring menstruation, and then go to the hormone level measurement. If the estrogen is low and the gonadotropins FSH and LH are high, it means that there is something wrong with the ovaries. If these hormones are low, it means that there is something wrong with the pituitary gland and hypothalamus.
Through this series of experiments, it is possible to figure out roughly which level is the problem, whether it is the reproductive tract or the ovaries, or the pituitary hypothalamus. According to the different levels, the corresponding diseases are looked for in these levels, and then these diseases are treated.