How should I manage vaginal bleeding associated with use of the copper intrauterine device (IUD)?

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How should I manage vaginal bleeding associated with use of the copper intrauterine device (IUD)?

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• Reassure the woman that menstrual irregularities (spotting, light bleeding, heavy and/or prolonged menstruation) are common in the first 3–6 months but usually subside. • Consider prescribing mefenamic acid for spotting/light bleeding or tranexamic acid for heavy and/or prolonged bleeding. • To prevent anaemia, provide an iron supplement and/or encourage consumption of foods containing iron.

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