A study of 300 Malaysian women who were fitted with the Copper-7 intrauterine device is presented. Two per cent of the acceptors were nulliparous. Insertion was easy in 97-7% of the cases and the side effects were minimal. In a study of over 4,634 women-months a low cumulative expulsion rate, at 12 and 24 months of use, of 3-1 and 3-6 respectively, was observed. However, relatively high cumulative rates of pregnancy of 4-3 and 9-2 occurred at 12 and 24 months of use respectively. Out of a total of 19 pregnancies, in 12 cases the device was found to have descended, a finding not commonly reported. One woman experienced translocation of the device five months after insertion, and in this instance, the device was removed by laparotomy. The findings in this study and their implications are discussed.
The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.