[Contraception and bleeding disorders--diagnostic contributions by ultrasound]

Practically all widely used and safe and reversible methods of contraception exert a direct (or at least an indirect) impact on the endometrium. Not surprisingly, abnormal uterine bleeding is a frequent adverse reaction associated with contraception. In this situation sonography--in particular transvaginal sonography--offers the physician a practically non-invasive imaging technique for determining the etiology of abnormal uterine, cervical or vaginal bleeding. Ultrasonographic imaging provides the physician with a detailed picture of the internal reproductive organs. It can also be used to monitor the efficacy of the particular contraceptive method. e.g. to check the position of IUDs, confirm the suppression of ovarian follicle activity in women taking ovulation inhibitors, detect ovarian cysts as a focus of undesirable hormonal activity, etc. In some cases, the failure of contraception, namely pregnancy, can be diagnosed by ultrasound. By using high-frequency linear ultrasonographic probes, the physician can verify the position of subcutaneous contraceptive implants on the medial upper arm. Therapeutic consequences can be derived, in particular, from the ultrasonographic measurement of the total thickness of the endometrial layer.