Takaisin Tulosta

NSAIDs for heavy bleeding or pain associated with IUD use

Evidence summaries
Last reviewed as up-to-date 4.9.2019Latest change 4.9.2019

Level of evidence: A↑↑

Non-steroidal anti-inflammatory drugs are effective compared with placebo in reducing bleeding and pain associated with IUD use.

Strong recommendation for using an intervention:

NSAIDs are recommended over no treatment for heavy menstrual bleeding in patients with IUD and who wish to continue using non-hormone-releasing IUD and do not get sufficient relief from tranexamic acid.

A Cochrane review «»1 «Grimes DA, Hubacher D, Lopez LM, Schulz KF. Non-st...»1 included 15 trials involving a total of 2 702 women from both developed and developing countries. NSAIDs (naproxen, suprofen, mefenamic acid, ibuprofen, indomethacin, flufenamic acid, alclofenac, and diclofenac) were effective in reducing menstrual blood loss associated with IUD use. This held true for women with and without complaints of heavy bleeding. NSAIDs were effective in reducing pain associated with IUD use. In contrast, prophylactic use of NSAIDs had mixed results; studies with ibuprofen found no effect on pain after insertion on IUD discontinuation. No important differences emerged in the one trial comparing the effect of different NSAIDs on bleeding.

A systematic review evaluated interventons for bleeding irregularities during Cu-IUD use. NSAIDs significantly reduced menstrual blood loss or bleeding duration among Cu-IUD users with heavy or prolonged menstrual bleeding (10 trials).


  1. Grimes DA, Hubacher D, Lopez LM, Schulz KF. Non-steroidal anti-inflammatory drugs for heavy bleeding or pain associated with intrauterine-device use. Cochrane Database Syst Rev 2006 Oct 18;(4):CD006034 [Last assessed as up-to-date: 17 August 2011]. «PMID: 17054271»PubMed
  2. Godfrey EM, Folger SG, Jeng G et al. Treatment of bleeding irregularities in women with copper-containing IUDs: a systematic review. Contraception 2013;87(5):549-66. «PMID: 23199413»PubMed