Title: A risk-benefit assessment of the levonorgestrel-releasing intrauterine system.

POPLINE Document Number: 120193

Author(s):

Sturridge F
Guillebaud J

Source citation:

DRUG SAFETY, 1996 Dec;15(6):430-40.

Abstract:

The levonorgestrel-releasing intrauterine system (LNG-IUS) provides fertility control comparable to female sterilization, convenience, and complete reversibility. This method appears to combine the benefits of oral contraception and the IUD, while avoiding most of their side effects. The low level of LNG released (20 mcg every 24 hours) minimizes the systemic adverse effects associated with hormonal contraception. Unlike inert or copper IUDs, the LNG-IUS is associated with a profound reduction in the duration and quantity of menstrual bleeding and alleviates dysmenorrhea. Moreover, there is evidence that the LNG-IUS prevents the endometrial proliferation associated with estradiol therapy and induces regression of endometrial hyperplasia; its potential for regulating the growth of uterine fibroids and preventing pelvic inflammatory disease remains undetermined. Although large multicenter studies have not detected differences in cervical cytology or breast cancer incidence between copper IUD and LNG-IUS users, long-term epidemiological studies are needed to confirm this finding. Fundal positioning of the LNG-IUS is essential to ensure uniform exposure of the endometrium to the progestogen, prevent expulsion, and maximize efficacy. A promising future use for the LNG-IUS is in protecting the endometrium during postmenopausal hormone replacement therapy. Overall, the research suggests that the LNG-IUS comes close to meeting many of the requirements of an ideal contraceptive.

Keywords:

Literature Review
Levonorgestrel
IUD, Hormone Releasing
Endometrial Effects
Side Effects
Contraceptive Agents, Side Effects
IUD Side Effects
Women
Contraceptive Agents, Progestin
Contraceptive Agents, Female
Contraceptive Agents
Contraception
Family Planning
IUD
Contraceptive Methods
Endometrium
Uterus
Genitalia, Female
Genitalia
Urogenital System
Physiology
Biology
Treatment
Demographic Factors
Population