Abstract
Abstract Objectives: to identify the main indications and reasons for discontinuing the use of the Levonorgestrel-Releasing Intrauterine System (LNG-IUS). Methods: a cross-sectional study was carried out from medical records of 327 women who used the LNG-IUS 52mg between January 2011 and December 2016 at a public hospital in the Northeast of Brazil. Results: the main indications for the use of the LNG-IUS were: contraception (32.7%), myoma/metrorrhagia (28.7%) and endometriosis/pelvic pain (22.3%). Of the 327 women, 68 (20.8%) had discontinued using the device. The most frequent reasons for discontinuation were: expulsion (9.2%), LNG-IUS expiration (3.7%), bleeding (2.4%) and pain (1.5%). Most patients had no difficulty in the insertion and did not require anesthesia/sedation. Among the 30 women who expelled the device, 17 (56.7%) had used it for metrorrhagia and myoma, 8 (26.7%) for contraception, and 5 (16.6%) for endometriosis/pelvic pain. Conclusions: the LNG-IUS is a well-accepted contraceptive method, with therapeutic applications for some gynecological conditions and a low expulsion rate.
Highlights
The Levonorgestrel-Releasing Intrauterine System (LNG-IUS) was initially developed as a device for contraception
Non-contraceptive benefits of the LNG-IUS, including treatment of abnormal uterine bleeding, were reported in a systematic review conducted in 2015.5 Currently the LNG-IUS is recommended as the first-line treatment for menorrhagia in the United Kingdom, and it is approved in 120 countries as a contraceptive method and in 115 countries to control menorrhagia.[6]
Among the main indications to use the LNG-IUS device, 107 women (32.7%) chose this method for contraception; 94 (28.7%) women chose for treating myoma and/or metrorrhagia; 73 (22.3%) for endometriosis associated with pelvic pain, and 27
Summary
The Levonorgestrel-Releasing Intrauterine System (LNG-IUS) was initially developed as a device for contraception. Among other non-contraceptive uses, other researchers have reported proven benefits of the LNG-IUS in the management of dysmenorrhea by decreasing pelvic pain, premenstrual syndrome (PMS) and to treat endometriosis and adenomyosis.[7,8]. On the basis of the WHO eligibility criteria, the LNG-IUS can be used safely by both multiparous and nulliparous women, as well as by women in other clinical situations. It is contraindicated in cases of suspected or confirmed breast cancer, malignant disease in the cervix, malformation or distortion of the uterine cavity, active pelvic infection, suspected or confirmed pregnancy, and uterine bleeding of unknown etiology.[8,9]
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