Abstract
The aim of this review was to summarize the available evidence about the use of levonorgestrel-releasing intrauterine system (LNG-IUS) as a contraceptive method in nulliparous women. For this purpose, studies evaluating the efficacy, safety, bleeding pattern, satisfaction and discontinuation of the levonorgestrel-releasing intrauterine system in nulliparous women were analyzed. Only original research articles published in English between 1990–27th March 2020 were considered eligible. Reviews, book chapters, case studies, conference papers, opinions, editorials and letters were excluded. The systematic literature search of PubMed/MEDLINE, Scopus, Embase and Cochrane Library databases identified 816 articles, 23 of which were analyzed. The available evidence indicates that LNG-IUS is an effective and safe contraceptive method for nulliparous women that achieves high levels of satisfaction among patients. Moreover, nulliparous women seem to experience fewer expulsions than parous ones. Bleeding pattern is acceptable for the majority of patients, and bleeding disorders mainly occur in the first months after the insertion. More in-depth, long-term prospective studies are needed in this patient group to determine risk factors for the occurrence of side effects and associated discontinuations, which should not, however, delay the wider use of the method in this group, given the number of advantages.
Highlights
IntroductionContraception (or birth control) is a deliberate use of methods or devices to prevent pregnancy as a consequence of sexual intercourse
Contraception is a deliberate use of methods or devices to prevent pregnancy as a consequence of sexual intercourse
A great progress in contraception research was observed in the 20th century, when contraceptives improved women s quality of life (QoL) and reduced various health conditions related to unplanned pregnancies [1,2]
Summary
Contraception (or birth control) is a deliberate use of methods or devices to prevent pregnancy as a consequence of sexual intercourse. A great progress in contraception research was observed in the 20th century, when contraceptives improved women s quality of life (QoL) and reduced various health conditions related to unplanned pregnancies [1,2]. Due to this revolution, couples may currently have sexual intercourse at any desired time [3]. Intrauterine devices are a form of long-acting reversible contraception (LARC) methods. They are placed in a woman s uterus. In addition to the aforementioned short-term effects, it reduces the lifetime risk of endometrial cancer and ovarian cancer [12]
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