Abstract
Objective: The levonorgestrel-releasing intrauterine system (LNG-IUS) is a long acting, safe, and reversible method that has a strong contraceptive effect. When using this method, menstrual bleeding disturbance and functional ovarian cysts are common. The objective of this study is to evaluate the relationship between using LNG-IUSs with the development of a functional ovarian cyst and bleeding disturbance in Turkish women. Material and methods: This is a prospective study including 273 Turkish women with regular menstrual cycles who had been administered LNG-IUS for contraception. We assessed their one-year follow-up results regarding bleeding patterns and functional ovarian cysts. Results: Oligomenorrhea was the most commonly seen menstrual bleeding disorder, seen in 13.5% of all subjects. Oligomenorrhea occurred in the 4-6th months of using a LNG-IUS in 70.27% of the subjects. During the one-year follow-up, 28% of the subjects who were administered LNG-IUSs had ovarian cysts. While 36.36% of the ovarian cysts occurred within 4-6 months, 57.14% of them appeared between 7-12 months. Conclusion: During 1-year short-term follow-up of those using LNG-IUSs, approximately one thirds of the subjects developed functional ovarian cysts and 13.5% of all complained of oligomenorrhea.
Highlights
The levonorgestrel-releasing intrauterine system (LNG-IUS) is used commonly for both contraceptive [1] and non-contraceptive indications such as the treatment of heavy menstrual bleeding or the prevention of endometrial hyperplasia during estrogen replacement therapy [2,3]
Oligomenorrhea occurred in the 4-6th months of using a LNG-IUS in 70.27% of the subjects
During 1-year short-term follow-up of those using LNG-IUSs, approximately one thirds of the subjects developed functional ovarian cysts and 13.5% of all complained of oligomenorrhea
Summary
The levonorgestrel-releasing intrauterine system (LNG-IUS) is used commonly for both contraceptive [1] and non-contraceptive indications such as the treatment of heavy menstrual bleeding or the prevention of endometrial hyperplasia during estrogen replacement therapy [2,3]. As the serum level of levonorgestrel varies largely among women; the inhibition of ovulation with an LNG-IUS occurs in very few women. Plasma estradiol (E2) and progesterone measurements are at a similar level to those of women who have normal ovulation [6] These effects are mostly seen in the first year of usage and in periods when ovulatory cycles occur [7]. The number of women removing LNG-IUS due to bleeding disturbance or oligo/amenorrhea varies to a large extent depending on the quality of consultation [11]
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