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Levonorgestrel-releasing implant is implanted under the skin in the upper arm of a woman, by creating a small incision and inserting the capsules in a fanlike shape. Insertion usually takes 15 minutes and the capsules can sometimes be seen under the skin, although usually they look like small veins. They can also be felt under the skin.
If the degree of bleeding is mild, all that may be sought is the reassurance that there is no sinister underlying cause. If anemia occurs due to bleeding then iron tablets may be used to help restore normal hemoglobin levels. [1] The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20]
Implants can be removed at any time if pregnancy is desired. The rod must also be removed by an experienced clinician. At removal, a local anesthetic is again used around the implant area at the distal end. [24] If the provider cannot feel the implant, imaging tests may be necessary to locate the rod before it can be removed.
Implantation bleeding may be confused with a regular period. [4] [5] Heavy vaginal bleeding in the first trimester or bleeding associated with pain, may be a sign of a complication, such as a miscarriage or an ectopic pregnancy, that would need to be assessed by a healthcare provider. [6]
In a 10-year study, the levonorgestrel coil was found to be as effective as oral medicines (tranexamic acid, mefenamic acid, combined oestrogen–progestogen or progesterone alone) for heavy periods; the same proportion of women had not had surgery for heavy bleeding and had similar improvements in their quality of life.
Other types of cancer include cervical cancer; bleeding in that case can sometimes be triggered by postcoital bleeding. Cancers of the vagina or fallopian tubes are rare causes of hemorrhage. Uterine fibroids represent a common, benign condition that may lead to bleeding, specifically if the lesion affects the uterine cavity.
Besides the aforementioned physiologic forms, IMB may also represent abnormal uterine bleeding and be a sign of an underlying disorder, such as a hormone imbalance, endometriosis, uterine fibroids, uterine cancer, or vaginal cancer. [citation needed] If the bleeding is repeated and heavy, it can cause significant iron-deficiency anemia.
One-third of women will experience abnormal uterine bleeding in their life. Normal menstrual cycle has a frequency of 24 to 38 days, lasts 7 to 9 days, so bleeding that lasts longer could be considered abnormal. Very heavy bleeding (for example, needing to use 1 or more tampons or sanitary pads every hour) is another symptom. [19]