The Comparative Effect of Capsella bursa-pastoris and Mefenamic Acid on Sexual Function of Copper IUD Users

Intrauterine device (IUD) is one of the most common ways of pregnancy prevention which is widely used in the world. About 13.9% of population of developed countries and 8.9% of population of developing countries use IUDs. According to the world statistics in 2013, approximately 7.6% of females in pregnancy ages use IUD (1). The IUDs containing copper were introduced to the world markets in late 1960s and nowadays are available in various types (2), from which Tcu380A is the most effective kind (3). IUD is for longtime use and has been considered as an irreversible pregnancy prevention method for 10 years (4). IUDs are not only effective and safe for pregnancy prevention, but also they have very important health advantages; for instance, IUD protects endometrium against cancer (5). In addition, copper IUDs do not create any disorders in pregnancy and the rate of unexpected pregnancies is less in IUD users compared to the users of other methods (6). Despite the wide use of IUD, early interruption of this method is considered a major problem and early IUD exodus causes pain and bleeding along with menstruation (7). Besides, use of IUD with increasing irregular uterine bleedings decreases the number of sexual intercourses and accordingly the sexual functioning (8). Sexual disorders may result from mental and physical factors. In cases with a physical reason for sexual problem, mental factors may play secondary role in complicating the condition and can cause disorders in sexual responses and dysfunctions (9). Paying attention to the sexual health in users of pregnancy prevention methods can have a role in the continuous use of prevention methods. Lack of attention to females’ sexual health leads to the incorrect use of pregnancy prevention methods and accordingly unwanted pregnancies, induced and unhealthy abortions, and some other problems (10). Using non-steroidal anti-inflammatory drugs except Abstract Objectives: Intrauterine device (IUD) is one of the most common methods of pregnancy prevention that is widely used in the world. Bleeding is one of the key reasons of stopping the use of IUD. Vaginal bleeding can be occurred due to the reduction of adequate motivation and functioning of neuroendocrine system and subsequent hormones (oxytocin, serotonin); and accordingly sexual functioning would be decreased. Therefore, the hemostatic impact of Capsella bursa-pastoris through several mechanisms can play a leading role in increasing the orgasm and sexual responses. The aim of current study was to determine the impact of C. bursa-pastoris on sexual functioning of females having copper IUD. Materials and Methods: This triple blind clinical trial was done in 2014 on 90 females visiting healthcare centers of Ardebil city, Iran. Women were complaining about excessive menstrual bleeding which occurred at least 3 months after placing IUDs. The first group received C. bursa-pastoris (700 mg) and the second group received mefenamic acid (500 mg) from first day of menstruation till bleeding completion, one every 8 hours. The questionnaire of sexual functioning was completed by the participants prior and 3 months after the treatment. The analysis of covariance (ANCOVA) test was used for comparing sexual functioning after the intervention among the studied groups with some adjustments on baseline scores. Results: Mean (standard deviation) score of sexual functioning in mefenamic acid group was 23.39 (4.18) before the intervention which was increased to 24.24 ± 3.45 after applying intervention. In C. bursa-pastoris group, mean (standard deviation) score of sexual functioning was 21.40 (4.70) before the intervention which was increased to 24.85 ± 3.81 after applying intervention. According to the findings of study, mefenamic acid and C. bursa-pastoris were effective in improving the sexual functioning, but increase of sexual functioning score after the intervention was significant in the C. bursa-pastoris group (the justified mean difference: 0.60, 95% CI [-0.91–2.13], P = 0.01). Conclusions: Capsella bursa-pastoris can be more effective compared to chemical drugs including mefenamic acid in increasing the sexual functioning of females with IUD.