Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS

Jeffrey T Jensen, Paula H Bednarek
International journal of women's health · 2009 · vol. 1 , pp. 45 · doi:10.2147/ijwh.s4350 · PMID:21072274 · W2074848702
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

The levonorgestrel-releasing intrauterine system (LNG-IUS) is a highly effective, reversible contraceptive that also benefits patients with gynecological conditions and offers endometrial protection.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reviews the safety, efficacy, and patient acceptability of the levonorgestrel-releasing intrauterine system (LNG-IUS) for both contraceptive and non-contraceptive uses, describing its mechanism (52 mg levonorgestrel released initially at 20 µg/day), contraceptive effectiveness, and outcomes such as return to fertility and changes in menstrual bleeding. It reports a typical-use first-year pregnancy rate of about 0.1%, approval for 5 years with evidence of effectiveness up to 7 years, and rapid post-removal fertility return with 1-year pregnancy rates of 89 per 100 for women under 30. The key non-contraceptive finding emphasized is the LNG-IUS’s strong local endometrial effects that benefit women with benign gynecological conditions including menorrhagia, dysmenorrhea, leiomyomata, and specifically adenomyosis and endometriosis; a stated limitation is that the paper is a review rather than new primary data. Relevance to endometriosis: the paper explicitly cites LNG-IUS benefits for both adenomyosis and endometriosis, framing its endometrial local effects as the rationale for those non-contraceptive uses.

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Abstract

Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS Paula H Bednarek, Jeffrey T JensenDepartment of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USAAbstract: Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 µg daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% – similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device’s strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia.Keywords: levonorgestrel intrauterine system, LNG-IUS, intrauterine device, IUD, IUS
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Abstract

Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 µg daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% – similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device’s strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia.

Keywords

levonorgestrel intrauterine system, LNG-IUS, intrauterine device, IUD, IUS © 2009 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms and incorporate the Creative Commons Attribution - Non Commercial (unported, 3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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endometriosisadenomyosisdysmenorrhea

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