Dr. LALITHA ANANTHASUBRAMANI AM

   AYAPON IN POST INSERTIONAL  BLEEDING

By

Dr. LALITHA ANANTHASUBRAMANIAM, M.S., D.G.O.

Associate Professor of Obstetrics & Gynaecology. Madras Medical College, Obstetrician & gynecologist,
Postpartum Programme, Govt. Kasturba Gandhi Hospital, Madras.

Dr. R. KASTHURI, M.B.B.S.

Urban Family Planning Clinic,
Govt. Kasturba Gandhi Hospital, Madras.

Dr. JAVA RAJENDRAN, M.B.B.S., D.G.O.

Assistant Surgeon, Urban Family Welfare Planning Clinic, Govt. Kasturba   Gandhi Hospital, Madras.  

Post insertional Bleeding after the intrauterine device is the most common complication, which had made a decline in the popularity of IUD as ideal for fertility control. Many workers have studied this problem and have come to the con­clusion that post insertional bleeding is of dys­functional type. The drugs that are used to les­sen this side effect are many. Being uneconomical and also variable’ in their effects, the patients are forced to ask for the removal of the device and they also scare new patients from adopting this method of contraception.

MATERIALS AND METHODS

AYAPON (Alarsin), a simple combination of ayapon, Ashoka, nagkeshar and god anti dis­pensed in a tablet form, is claimed to control functional uterine bleeding, including that caused   by   IUD.   So a clinical trial with  ‘AYAPON’ in post insertional bleeding was con­ ducted in 50 cases of IUDs in comparison with a Control Group of 50 cases.

50 cases fitted with IUDs were put on AYAPON tablets as prophylaxis in a dosage schedule of 1 tablet three times daily, for 20 days, for three cycles, commencing from the first day of insertion.

OBSERVATIONS AND RESULTS

Table I shows that NO COMPLAINTS group in the control group was 66%; this has im­proved to 96% in the Ayapon Group, which is statistically significant. While bleeding cases in the control group were 22%, it was only 4% in the Ayapon group. While Expulsions and Re­movals in the control group were 12%, the con­tinuation rate in Ayapon group was 100%, with­out any expulsions or removals, which is highly significant.

Table I

    Events                      Control group              Trial group

Complaints 33 (66%) 48 ( 96%)
Spotting of Blood 4 ( 8%)

1 (2%)
 Bleeding P.V. 7  (14%) 1 (2%)
Expulsions 2 (  4%)   Nil
Removals 4(  8%) Nil
Total 50 (100%) 50 (100%)

Table II clearly shows the steady increase in the number of IUD insertions, which reflects to the good disposition towards the same due to effective control of post insertional bleeding in those who had already fitted the device. The comparison is made for the months Dec. 1973 to March 1974 and for the same months, Dec. 1974 to March 1975, correspondingly. While the number of insertions were only 73 between Dec. 1973 to March 1974, for the, corresponding period, Dec. 1974 to March 1975, the number of insertions rose to 132. The acceptance of any method of family planning is directly proportioned to the minimal side effects and complications. One satisfied patient brings many more to the clinic as shown by the steady rise in the number of insertions.

Table II

   Month                       Total No. of         Month             Total No. of
Year                       Insertions           year                   Insertions

Dec.1973 20 Dec 1974 10
Jan.1974 19 Jan. 1975 35
Feb.1974 15 Feb. 1975 34
March 1974 19 March 1975 53
Total 73 132

Chart 1 gives the comparison of Removals, Expulsions, Bleeding P. V., Spotting of Blood and  NO COMPLAINTS between the Ayapon Group and Control Group. The chart clearly shows the better results of the Ayapon Group.

Chart 2 shows the steady improvement in the number of IUD insertions for the two years under comparison and for the same calendar months. The increase in the number of IUD insertions is clearly  attributed to the confidence of the patients of the Ayapon Group who were benefited by better results themselves and recommended others to have IUD.

SUMMARY AND CONCLUSIONS

  1. Ayapon prevents post insertional bleeding clinically and increases continuation rate, expulsions and removals being nil. 
  2. The prophylactic use of this drug psychologically improves patient’s confidence and acceptance to IUD, as the dreaded complication of post insertional bleeding, which is the main cause of unpopularity of this safe, simple and economical method of contraception, is prevented by the use of AYAPON.
  3. It is suggested that this drug be used prophylactically and given free to all patients accepting IUD to improve the acceptance rate of IUD as this indigenous drug is cheap, safe and without side effects.

ACKNOWLEDOEMENT

We thank Dr. A. Sitaratna, MD, DGO Superintendent, Govt. Kasturba Gandhi Hospital, Madras-5, for allowing us to undertake this trial and publish this report

We thank Manthan, Research Division of Alarsin, Bombay-1 for  the trial.

REFERENCES

  • Mrs. Kamal B. Kodkany. Use of Ayapon in uterine Bleeding after IUCD – Indian Prac. Vol. XXI, No.12, P.N. 901, Dec 1968.
  • Mrs. Ursekar, G.  D.:  _Ayapon’  to  control bleeding  after  IUCD – Mah.  Med. Journal Vol. XX, No.3, P.No.111, JUne 1973 

     

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