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I may post this question to fam, but there's always someone who heckles IUD users and I'm not really in the mood for fending off flame wars. Anyway, I do FAM charting so I know when I ovulate and can see exactly how my pattern varies from what's expected.

I've had a copper IUD for three and a half years, and I get a fair amount of spotting with it. Sometimes the spotting is random, but most often it starts about five days before ovulation and continues until a day or so after it. Or rather, I always get it during my fertile phase, and sometimes get random spotting at other times as well. As is common with IUD users, I get a lot of fertile cervical fluid (known as eggwhite), which I believe is caused by the IUD strings stimulating the cervix. A day or so of spotting around ovulation is meant to be a sign of high fertility, extra oestrogen I think. It's as if I've moved up a notch with fertility signs: instead of getting six days or so of eggwhite leading up to ovulation, I get eggwhite most of my cycle and the spotting at the time when someone without an IUD would be getting eggwhite, during my fertile phase.

I've heard that spotting from copper IUDs is caused by slight degradation of the copper irritating the endometrium, but you'd expect that to be random and mine seems to be following a particularly hormonal pattern. Does anyone have a theory as to what's going on here? And incidentally, does anyone know if there are breeds of copper IUD which are less likely to cause extra bleeding or spotting? I've heard that there are copper alloy IUDs in Europe called GoldLily and SilverLily which are good for this, and I'm also wondering about GyneFix, especially the mini version.

In better news, I've been taking 4g echium oil daily for the last couple of months, and my periods, which had doubled in length, have gone back to the three days they were before the IUD. They're still a smidgen heavier, and I get spotting before and after them, but this is a great improvement. Echium oil is meant to be the best vegetarian alternative to fish oils, and I've read up on people having a similar experience with fish oils or evening primrose oil.

Comments

( 10 comments — Leave a comment )
danalea83
Oct. 26th, 2009 01:21 pm (UTC)
Hey! I know you from the pmdd community. I also have a copper IUD, and I use a menstrual cup pretty much every day because the IUD causes me to have so much cervical mucous. During my fertile phase there is always a tiny bit of blood in the cup. It wouldn't be noticeable if I didn't have the cup in though, so I wouldn't call it spotting, but I think a bit of blood right around ovulation is pretty normal.

I didn't get longer or heavier periods from the IUD. I just have loads more mucous. I'm glad you found stuff that helps with your periods though. I was really worried that my periods would be insane with the IUD, but it didn't seem to affect them at all.

Edited at 2009-10-26 01:21 pm (UTC)
elettaria
Oct. 26th, 2009 01:32 pm (UTC)
When they talk about a bit of blood around ovulation being normal, they mean a day or so. Getting it for over a week isn't considered normal without an IUD; with an IUD, spotting just seems to get written off and it's hard to distinguish between what's normal and what isn't (I got extra bleeding when I had a cervical polyp, for instance). What I want to know is why I'm getting all this spotting throughout my fertile phase (and yes, it's more than you're reporting). Are the hormones and the IUD reacting together somehow?
nikki_kp
Oct. 26th, 2009 02:27 pm (UTC)
As I started reading, your words resonated with me. My cycles are currently very similar to yours. (ECM with blood and spotting from approximately three days after my period ends until a heavy spotting almost light flow at ovulation).

One particularly iud unfriendly doc said that it was because of sensitivity to the copper and kept insisting that it had to come out. Another said it was an abrasive effect of the copper on the new endometrial growth and prescribed 600 and then 800 mg Motrin to take during this part of my cycle (the three time per day suggestion seemed like overkill however as one pill a day worked just fine for the “inflammation”) A third doc said agreed that it was a matter of abrasion but also noted a possible vitamin deficiency. The suggestion was to take a BETTER multivitamin (which seems to have helped with my periods altogether) along with more calcium, zinc, and fish oils.
elettaria
Oct. 26th, 2009 05:01 pm (UTC)
*googles Motrin* Oh, ibuprofen. Can't take NSAIDs at all. Is it really a good idea to start living on them just for spotting? I mean, ulcers!

I hardly think that spotting is a reason to remove an IUD, especially considering that most of us are on IUDs as a last resort. Hormones do appalling things to me, and I can't be doing with the relatively high pregnancy rate of barrier methods and FAM. I'd just like to know exactly why it's happening, and wouldn't object if it were to stop.

Which multivitamin did you take before and what are you taking now? I'm seeing a doctor who's a nutritionist in a fortnight, so hopefully he'll be helpful there, although I don't think his little questionnaire included spotting, now I think of it.
nikki_kp
Oct. 27th, 2009 05:01 pm (UTC)
I didn't think it was a good reason either, so I went to see another doctor. :D Same with the /living/ on NSAIDs. I tried it, it worked, but the spotting isn't troublesome. I sometimes take one when I'm going to see my SO for some private time because he's pretty bloodphobic or if I have a bad headache. Otherwise I just put on a cloth pad.

Before I was using a super cheap drugstore brand with just C, A, B and E. I switched to One-a-Day Maximum with suppliemental B-complex, E, C, and Calcium depending on how my body is feeling. (C works for my heatrashes, B when I need the extra boost for on workout days.)
iudmama
Oct. 27th, 2009 03:34 pm (UTC)
vitamin E and prostaglandins
Since the copper IUD changes prostaglandin levels and shortens the luteal phase, could a related hormonal fluctuation be the source of your mid cycle bleeding?

In this post a few days ago, mari_mac1109 linked to an article about vitamin E which discusses how E has a similar effect on prostaglandin levels as ibuprofen, leading to reduced cramping and blood loss during menstruation, but without the typical health risks of ibuprofen.

I know the article focuses on reducing symptoms during menstruation, but I'm wondering if vitamin E could be helpful for mid cycle bleeding, too?
Might be worth trying.
elettaria
Oct. 28th, 2009 11:59 am (UTC)
Re: vitamin E and prostaglandins
Could you give me some references for the prostaglandin/LP thing? My PMS started at the same time that I got my IUD, and PMS is related to short LPs (my LP is 9 days on average). After being reassured by several doctors that copper IUDs don't alter hormone levels, I eventually put the PMS down to the sudden weight gain that happened at the same time. I didn't chart before the IUD, so I don't know what my LP was before. Your explanation makes the most sense of any I've heard, but I'm surprised as we're always told that copper IUDs don't interfere with hormones. I'm also wondering whether this prostaglandin business could be why I suddenly started to pack on weight when I got my IUD (and no, I hadn't been on hormonal contraception previously).

I generally see Vitamin E mentioned alongside EFAs so I suspect that any EFA oil will also have a good dose of Vitamin E in there as well, though as echium oil is fairly new there isn't much written about it and I can't find out yet. I might ask the manufacturers. Certainly my FAM chart is looking better than usual this cycle, and was fairly good last cycle as well (temps more even, temp drop starting before period rather than precipitously during it, less spotting). Hmm, now I'm googling this for fish oils and apparently they deplete Vitamin E, which is presumably why I'm linking them in my mind: the fish oil supplements often have extra Vitamin E added in.

I'll ask aforementioned doctor about this.

I wonder whether I'd be better off switching to the Gynefix Mini? It has just over half as much copper as my current IUD, though it's meant to be equally effective as a contraceptive.
iudmama
Oct. 28th, 2009 04:51 pm (UTC)
Re: vitamin E and prostaglandins
This Finnish study shows an increase in prostaglandin levels in IUD users at 3 months post insertion, but the elevated levels seem to taper off over time. This study has similar findings and suggests that although prostaglandin levels taper off over time, they still remain higher in IUD users.

The Finnish study references two other studies (Faundes et al., 1980; Anttila et al.,
1991) that have shown a shortened luteal phase in IUD users, with no change in the overall length of the menstrual cycle.

At this point, three and a half years with your IUD, it could be that your body is trying to adjust to decreasing prostaglandin levels and this may in turn be triggering some other hormonal reactions that are messing with your cycle.

With the EFAs and the echium oil, it will be interesting to see if there's any effect on your mid cycle bleeding.
Keep us posted!
elettaria
Oct. 29th, 2009 09:30 am (UTC)
Re: vitamin E and prostaglandins
I've e-mailed Dr Wildemeersch, the designer of GyneFix, to ask about all of this. I've corresponded with him in the past so I reckon he may be helpful.

I rang the FPA helpline and the advisor knew about the prostaglandins and shortened luteal phase, though she said she doubted that it would be enough to create any effect that I'd notice such as PMS. I'm not so sure about that last bit, as shortening the luteal phase changes the overall balance of hormones and there's a known correlation with PMS. Again she wasn't keen on GyneFix, few places insert it because of the higher risk of perforation. She also said that this level of spotting is not normal with an IUD and that I should get checked out. While we were at it, we both wondered about how often I should get an ultrasound done to check that the IUD is still there, since the strings vanished up into my cervix a while back. I'm now starting to worry that the reason I've had shorter cycles the last two months is due to unnoticed expulsion. I know you'd think that you'd notice an expulsion, but apparently 1/3 of IUD pregnancies are due to unnoticed expulsions.

If a GyneFix does turn out to be a better option, I'm starting to think that it might be easier just to switch to that than to keep having ultrasounds. Insertions don't bother me as much as ultrasounds, for various reasons, and a single trip would be less hassle than repeated ones. Though there's the increased risk of perforation problem, the snag that I can't access the main FPC due to lack of disability access, and I think the only gynae who does the outreach clinic is the one who's excellent at IUD insertion but was ghastly when I saw her for the PMDD, and would probably refuse to give me a GyneFix for these reasons.

With the weight gain, I gained about ten pounds over two months, then have been more gradually gaining weight since then, I think about another ten pounds. I'm 4'11 so this is a lot on me. The PMS has only recently begun to improve, but I think that's because I've finally found treatments that work.

Midcycle bleeding seems to be milder this month for whatever reason. About a week before this cycle began, I started doing graduated light/darkness therapy in the hope that it will balance my hormones. So far it's looking promising, and I'm also noticing slightly higher than usual temperatures, whatever that means. Anyway, if this really is balancing my hormones then it might be reducing the spotting as well.
sdnats
Feb. 15th, 2011 05:19 am (UTC)
Here's an academic paper on vitamin e and dysmenorrhea:
http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2004.00495.x/full
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