Which is the commonest side effect of copper-T among the following?

OSSSC Nursing Officer-2023

Obstetrics & Gynecology

Easy

Appeared in: OSSSC Nursing Officer-2023

Explanation

Pain, including uterine cramping and low backache, is a very common side effect of the Copper-T IUD, particularly in the first few months after insertion and during menstruation.
The device causes a local inflammatory reaction in the endometrium, leading to the release of prostaglandins which stimulate uterine contractions, causing pain and cramping.
Along with increased bleeding, pain is one of the primary reasons why women choose to have their IUDs removed.
Among the given options, pain is significantly more frequent than the rare complications of perforation or ectopic pregnancy, and unlike nausea, it is a direct local effect of the device.

Option B: Nausea is a systemic side effect typically caused by hormones. The Copper-T is a non-hormonal contraceptive, so it does not cause nausea.
Option C: Uterine perforation is a serious but rare complication of IUD insertion, with an estimated incidence of about 1 to 2 per 1,000 insertions. It is not a common side effect.
Option D: The Copper-T is highly effective at preventing pregnancy, so the absolute risk of an ectopic pregnancy is very low—lower than in women using no contraception. It is not a common outcome.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Side effects of Copper-T (Intrauterine Device) as background academic context rather than a clinical decision trigger.
A key nursing role is pre-insertion counseling. Informing patients that pain and heavier bleeding are common and usually decrease over time can manage expectations, reduce anxiety, and improve continuation rates.
Nurses must teach patients how to manage common side effects, such as using NSAIDs (like ibuprofen) for pain, and when to seek medical help.
Teaching the 'PAINS' mnemonic is a critical patient safety intervention for helping users recognize warning signs that require urgent medical evaluation.

How to Approach the Question

First, identify the key components of the question: the device ('copper-T') and the specific query ('commonest side effect').
Recall the mechanism of the Copper-T. It's a non-hormonal device that causes a local inflammatory reaction.
Consider the options in terms of frequency. Think about which effects are common versus which are rare but serious.
Evaluate each option: Nausea is hormonal. Perforation and ectopic pregnancy are known but rare risks.
Pain and cramping are direct, expected consequences of the device's presence and mechanism in the uterus, making it a very common experience.
Conclude that among the given choices, pain is the most frequent side effect.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 192-194