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Levonorgestrel-releasing implant is implanted under the skin in the upper arm [a] 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.
Other possible symptoms: Other symptoms that have been reported in trials of implants include headache, emotional lability, depression, abdominal pain, loss of libido, and vaginal dryness. [24] However, there have been no studies that conclusively determine that these symptoms are caused by the implant. [25] [26]
The average user reports 16 days of bleeding or spotting in the first month of use, but this diminishes to about four days at 12 months. [51] [52] Cramping and pain: many women feel discomfort or pain during and immediately after insertion. Some women may have cramping for the first 1–2 weeks after insertion. [53]
The muscles of the vagina keep NuvaRing securely in place, even during exercise or sex. Women can check the birth control ring periodically with their finger. In rare instances, NuvaRing may fall out during sexual intercourse, while straining before or during a bowel movement, or while removing a tampon.
In particular, prostaglandins induce abdominal contractions that can cause pain and gastrointestinal symptoms. [8] [9] The use of certain types of birth control pills can prevent the symptoms of dysmenorrhea because they stop ovulation from occurring. Dysmenorrhea is associated with increased pain sensitivity and heavy menstrual bleeding. [10] [11]
Coagulopathies (blood clotting disorders): Heavy menstrual bleeding can be related to coagulopathies. [23] Von Willebrand disease is the most common coagulopathy, and most women with von Willebrand disease have heavy menstrual bleeding. [23] Of women with heavy menstrual bleeding, up to 20% will have a bleeding disorder. [24]
The "Ma Rainey" actress shared that she struggled with uterine fibroids, noncancerous growths of the uterus that can cause heavy bleeding, infertility and, in some cases, miscarriages.
Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate , as well as blood tests to determine the hemoglobin .
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