Comparison of Menstrual Bleeding and Dysmenorrhea Following Immediate Postpartum Insertion of Copper-T 380A and Cu 375 Intrauterine Contraceptive Devices: A Prospective Observational Study.

Background Immediate postpartum intrauterine contraceptive device (PPIUCD) insertion is an effective method of long-acting reversible contraception. Differences in copper surface area and device design between Copper-T (Cu-T) 380A and Cu 375 may influence bleeding and pain profiles. Data in the immediate postpartum setting remains limited. Methods This prospective observational study compared postpartum women who received Cu-T 380A (n=150) with Cu 375 (n=150) as PPIUCD following vaginal or cesarean delivery. Participants were followed at six weeks and six months. The primary outcome was menstrual blood loss assessed using the Pictorial Blood Assessment Chart (PBAC) and dysmenorrhea assessed using the Visual Analog Scale (VAS). Secondary outcomes included expulsion, abnormal vaginal discharge, unintended pregnancy, removal, and satisfaction. Results Baseline characteristics were comparable between groups. At six weeks, PBAC and dysmenorrhea scores did not differ significantly. At six months, Cu-T 380A users demonstrated higher PBAC and dysmenorrhea scores compared with Cu 375 users (p < 0.001). The absolute difference in PBAC scores was modest but statistically significant, and median values in both groups remained below thresholds typically associated with heavy menstrual bleeding. Safety outcomes, expulsion rates, and satisfaction were similar between groups. Conclusion The present study highlights that although both the PPIUCD options Cu-T 380A and Cu 375 have good patient acceptability and high satisfaction scores, Cu-375 as a PPIUCD causes significantly less menstrual bleeding, as well as less severity and duration of dysmenorrhea, when compared to Cu-T 380A. Since complications at follow-up are a major determinant in PPIUCD acceptance, Cu-375 is a lucrative option for women opting for reversible contraception after delivery.