Levonorgestrel-Releasing Intrauterine Device: An Effective Treatment for Symptoms of Persistent Pelvic Pain

R. Cocks, Samantha Mooney, Grover SR, Sonia Grover, Sonia R Grover
The Australian & New Zealand journal of obstetrics & gynaecology · 2025 · vol. 65(6) , pp. 848–853 · doi:10.1111/ajo.70042 · PMID:40317543 · W4410035567
article OA: closed CC0 ⤵ 1 in-corpus citation
Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This study found that the levonorgestrel-releasing intrauterine device (LNG-IUD) significantly improved pain and satisfaction for women with persistent pelvic pain, irrespective of endometriosis diagnosis.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

BACKGROUND: Persistent pelvic pain (PPP) affects 5%-27% of women of reproductive age. The calls for earlier and improved access to surgery to diagnose endometriosis do not address the requirement for symptom management and exclude the 50% of women who undergo a laparoscopy for identical pain symptoms but do not have endometriosis identified. Moreover, current evidence for the management of pelvic pain almost exclusively focuses on patients diagnosed with endometriosis. AIMS: To investigate the pain scores and overall satisfaction with symptom control in participants with PPP who utilised the levonorgestrel-intrauterine device 52 mg (LNG-IUD), to explore the association between time since last menstrual period (LMP) and other potential factors, including the impact of surgery and surgical findings, on pain outcomes. MATERIALS AND METHODS: This prospective cohort study recruited participants between February 2015 and December 2017 following outpatient clinic referral for pelvic pain symptoms (dysmenorrhea, non-cyclic pelvic pain, dysuria, dyspareunia or dyschezia). Over 18 months, 72 participants had an LNG-IUD (52 mg) inserted, with 51 completing a follow-up questionnaire 6-18 months after insertion to assess pain outcomes. RESULTS: Dysmenorrhoea (coefficient = -0.142, p < 0.001) and overall satisfaction with symptom control (coefficient = 0.079, p = 0.020) scores improved linearly with increased months since LMP in LNG-IUD users. In multivariate analysis, the age of onset of symptoms, laparoscopies prior to study entry or during the study period, and a histological diagnosis of endometriosis did not have a significant relationship with pain outcome or overall satisfaction with symptom control. CONCLUSIONS: This study demonstrates that menstrual suppression with the LNG-IUD, regardless of a diagnosis of endometriosis, significantly improves a woman's overall satisfaction with PPP management. The LNG-IUD is an effective first-line medical management option for patients presenting with PPP.
Full text 2,267 characters · extracted from oa-doi-fallback · 4 sections · click to expand

Abstract

Background Persistent pelvic pain (PPP) affects 5%–27% of women of reproductive age. The calls for earlier and improved access to surgery to diagnose endometriosis do not address the requirement for symptom management and exclude the 50% of women who undergo a laparoscopy for identical pain symptoms but do not have endometriosis identified. Moreover, current evidence for the management of pelvic pain almost exclusively focuses on patients diagnosed with endometriosis. Aims To investigate the pain scores and overall satisfaction with symptom control in participants with PPP who utilised the levonorgestrel-intrauterine device 52 mg (LNG-IUD), to explore the association between time since last menstrual period (LMP) and other potential factors, including the impact of surgery and surgical findings, on pain outcomes.

Materials and methods

This prospective cohort study recruited participants between February 2015 and December 2017 following outpatient clinic referral for pelvic pain symptoms (dysmenorrhea, non-cyclic pelvic pain, dysuria, dyspareunia or dyschezia). Over 18 months, 72 participants had an LNG-IUD (52 mg) inserted, with 51 completing a follow-up questionnaire 6–18 months after insertion to assess pain outcomes.

Results

Dysmenorrhoea (coefficient = −0.142, p < 0.001) and overall satisfaction with symptom control (coefficient = 0.079, p = 0.020) scores improved linearly with increased months since LMP in LNG-IUD users. In multivariate analysis, the age of onset of symptoms, laparoscopies prior to study entry or during the study period, and a histological diagnosis of endometriosis did not have a significant relationship with pain outcome or overall satisfaction with symptom control.

Conclusions

This study demonstrates that menstrual suppression with the LNG-IUD, regardless of a diagnosis of endometriosis, significantly improves a woman's overall satisfaction with PPP management. The LNG-IUD is an effective first-line medical management option for patients presenting with PPP. Conflicts of Interest The authors declare no conflicts of interest.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

dysmenorrheaendometriosischronic_pelvic_paindyspareunia

MeSH descriptors

Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female Contraceptive Agents, Female

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)

Cited by (1)

Source provenance

europepmc
last seen: 2026-07-27T06:15:28.040536+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-07-27T06:11:39.001876+00:00
License: CC0 · commercial use OK