The significance of calcium deposits occurring on intrauterine devices
Howard, G.
Journal of Obstetrics and Gynaecology of the British Commonwealth 78(9): 861-862
1971
ISSN/ISBN: 0022-3204 PMID: 4255470 DOI: 10.1111/j.1471-0528.1971.tb00354.xDocument Number: 519393
At the Charing Cross Hospital (England) and Family Planning Association Clinics, 121 IUDs were examined after removal from patients. There were 92 Lippes loops, 10 Saf-T-Coils, and 19 Birnberg bows. 71 IUDs were from patients who had symptoms of menorrhagia; 50 were from patients who were symptom free. The IUDs were graded 0-3 according to the amount of calcium deposit on each device: 0, no deposit at all; 1, smooth on sight but minimal roughness felt in some areas; 2, deposit visible on less than half the surface of the device; and 3, deposit visible on more than half the surface of the device. When the deposit was scraped off a smooth unaltered surface remained with no pitting or erosion. The extent of the deposit appeared to be related to the time the IUD had been retained. It also appeared that the deposits occurred more frequently on the Lippes loops and Saf-T-Coils, after the same average time, than on the Birnberg bows. Enquiries from the manufacturers failed to elucidate any chemical reasons for this. Of the 92 Lippes loops examined, 12 were not included in the investigations because they came from patients who were postmenopausal (2 cases), requested removal for pregnancy (5 cases), were extruding the device (4 cases), and 1 who had an early pregnancy. Of the remaining 80 patients, 44 had menorrhagia and of these 7 were excluded because of other causes for the menorrhagia (2 distorted loops, 1 loop partially embedded in cervical canal, 3 patients with pelvic inflammation, and 1 patient with a fibroid). There remained 36 patients without symptoms of menorrhagia and 37 patients with menorrhagia. The incidence of menorrhagia was unrelated to the roughness of the Lippes loop. When patients using other devices were considered 2 using Saf-T-Coils and 1 using Birnberg bow were excluded for similar reasons, leaving 15 devices coming from patients without symptoms and 11 from patients with menorrhagia. No relation was shown between the incidence of menorrhagia and the time of retention. It is concluded that the degree of roughness had no relation to the menorrhagia. The calcium deposit on an IUD does not appear to produce menorrhagia and other causes should be considered for this symptom occurring when an IUD is in use.