Levonorgestrel-releasing intrauterine device used for dysmenorrhea: five-year literature review

A Imai, Atsushi Imai, Imai A, Matsunami K, K. Matsunami, Hiroshi Takagi, Takagi H, H Takagi, Satoshi Ichigo, S Ichigo, Ichigo S
Clinical and experimental obstetrics & gynecology · 2014 · vol. 41(5) , pp. 495–498 · doi:10.12891/ceog17042014 · PMID:25864246 · W2205123946
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

The levonorgestrel-releasing intrauterine device effectively reduces dysmenorrhea in various patient populations and is comparable or superior to systemic treatments.

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This paper is a five-year literature review examining the efficacy and safety of the levonorgestrel-releasing intrauterine device (LNG-IUD) for dysmenorrhea, summarizing findings across studies in women with varying causes of pain and menstrual problems. The review reports that dysmenorrhea decreases overall, that LNG-IUD appears superior to copper IUDs for improving dysmenorrhea, and that it may help with symptom recurrence and endometriotic cyst recurrence after conservative surgery for endometriosis-related severe pain, with evidence also noted for severely obese adolescent females. It highlights that while IUD expulsion is rare, risk is higher in women with distorted uterine cavities, and it states overall the LNG-IUD is equal or superior to systemic progestins or oral contraceptives for dysmenorrhea across adolescent and menopausal populations. This paper directly relates to endometriosis and adenomyosis by citing the LNG-IUD as beneficial for dysmenorrhea associated with both conditions and by specifically discussing endometriotic cyst recurrence after conservative surgery.

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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 IUD (LNG-IUD), originally designed for long-term contraceptives, is now recognized to provide non-contraceptive health benefits. These include severe dysmenorrhea and/or heavy menstrual bleeding associated with uterine myoma, endometriosis, and adenomyosis. This report aims to review the last five-year literature on the efficacy and safety of the LNG-IUD in women with dysmenorrhea. Dysmenorrhea has been reported to decrease in all women. LNG-IUD seems to be superior over copper-releasing IUD for improving dysmenorrhea. The LNG-IUD is beneficial for symptom recurrence and endometriotic cyst recurrence after conservative surgery for patients with severe pain related to endometriosis. There is also evidence to support its role in menstrual problems of severely obese adolescent females. Expulsion, one of the important factors for IUD acceptability, is rare but more common in women with distorted uterine cavity. In the treatment of dysmenorrhea, the LNG-IUD is equal or superior to treat with systemic progestins or oral contraceptives even in adolescent or menopausal women.
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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 IUD (LNG-IUD), originally designed for long-term contraceptives, is now recognized to provide non-contraceptive health benefits. These include severe dysmenorrhea and/or heavy menstrual bleeding associated with uterine myoma, endometriosis, and adenomyosis. This report aims to review the last five-year literature on the efficacy and safety of the LNG-IUD in women with dysmenorrhea. Dysmenorrhea has been reported to decrease in all women. LNGIUD seems to be superior over copper-releasing IUD for improving dysmenorrhea. The LNG-IUD is beneficial for symptom recurrence and endometriotic cyst recurrence after conservative surgery for patients with severe pain related to endometriosis. There is also evidence to support its role in menstrual problems of severely obese adolescent females. Expulsion, one of the important factors for IUD acceptability, is rare but more common in women with distorted uterine cavity. In the treatment of dysmenorrhea, the LNG-IUD is equal or superior to treat with systemic progestins or oral contraceptives even in adolescent or menopausal women.

Keywords

- Intrauterine device - Dysmenorrhea - Levonorgestrel-releasing intrauterine device (LNG-IUD) - Adenomyosis - endometriosis

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Condition tags

dysmenorrheaendometriosisadenomyosis

MeSH descriptors

Dysmenorrhea Intrauterine Devices, Copper Levonorgestrel Contraceptive Agents, Female Contraceptive Agents, Female Dysmenorrhea Female Humans Levonorgestrel Time Factors

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (33)

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