Non-contraceptive benefits of intrauterine levonorgestrel administration: why not?

Lorenzo Sabbioni, Sabbioni L, Felice Petraglia, Petraglia F, Stefano Luisi
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2017 · vol. 33(11) , pp. 822–829 · doi:10.1080/09513590.2017.1334198 · PMID:28586290 · W2622073495
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This paper reviews the noncontraceptive benefits of levonorgestrel intrauterine systems for gynecological conditions like abnormal bleeding and fibroids, arguing for their broader use beyond contraception.

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Abstract

Levonorgestrel intrauterine systems (LNG-IUS) represent a modern therapy for an array of preexisting gynecological conditions, though they were first marketed in Finland in 1990. However, there are countries in which their use is extremely limited by social and cultural factors. This manuscript describes the possible reasons for this misuse, taking in consideration the clinical noncontraceptive benefits of intrauterine levonorgestrel in routinary practice. Medical diseases in which LNG-IUS represent a treatment include abnormal uterine bleeding, iron-deficiency anemia, endometrial hyperplasia, uterine fibroids, adenomyosis, endometriosis, and coagulopathies. The advantage of reducing the need for more radical treatments such as surgery or hysterectomy is well demonstrated, with remarkable benefits for patients. However, in many countries, surgery is still used as a first-line treatment and there is a need to define who could benefit from a less invasive option. It seems clear that such a reduced use of LNG-IUS depends on factors that imply both patients and practitioners, and that the role of counseling is becoming a key component in the decision-making process to reach the ultimate goal of compliance.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Contraceptive Agents, Female Genital Diseases, Female Intrauterine Devices, Medicated Levonorgestrel Contraceptive Agents, Female Female Genital Diseases, Female Humans Intrauterine Devices, Medicated Levonorgestrel

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License: CC0 · commercial use OK