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[Changes in the levels of precursors of endogenous synthesis of prostaglandins in intrauterine contraception].


 To evaluate the mechanism of early complications associated with the use of IUD, the metabolism of polyunsaturated fatty acids (precursors of the synthesis of endogenous prostaglandins) was studied in 136 women aged 20-35 years old. All women were using Lippes Loop. Of 136 women, 71 received IUD on day 4-6 of the menstrual cycle (Group 1) and 65 received IUD after induced abortion (Group 2). The women used IUD for up to 1 month (26 in Group 1 and 23 in Group 2), for up to 3 months (24 and 21, respectively), and up to 6 months (21 and 21, respectively). The levels of linoleic, linolenic and arachidonic acids in the venous blood were determined by gas-liquid chromatography. After 1-month use of IUD, there was a significant increase in the blood levels of polyunsaturated fatty acids, compared with controls (women who did not use IUD); the increase was more pronounced in women from Group 2. After 3 and 6 months, the levels of linoleic, linolenic and arachidonic acids showed gradual decrease but remained higher than in controls. Average duration of the menstrual cycle in women from Groups 1 and 2 decreased by 2.1 and 3.6 days, respectively. Complications (pain during menstruation) were more frequent in Group 2 (38.4%, compared with 22.5% in Group 1). These findings indicated that insertion of IUD resulted in significant modification of the metabolism of polyunsaturated fatty acids and stimulation of prostaglandin synthesis. Marked increase in the levels of linoleic linolenic and arachidonic acids during the first 6 months after the use of IUD was indicative of the existence of the adaptation period.
