Side Effects of levonorgestrel intrauterine system: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Main research findings

The levonorgestrel intrauterine system (LNG-IUS) is widely used for contraception and the treatment of heavy menstrual bleeding. 15 A meta-analysis of seven randomized controlled trials suggested that the LNG-IUS may be more effective and affordable than thermal balloon ablation for long-term treatment (24 months) of heavy menstrual bleeding. However, the LNG-IUS was associated with a higher incidence of amenorrhea compared to thermal balloon ablation. 17 A case report described acute urticaria following the insertion of the LNG-IUS. 13 A multicenter observational cohort study in Chinese women suggested that the LNG-IUS may be associated with a different bleeding pattern compared to the copper intrauterine device (Cu-IUD) inserted immediately after abortion.

Reasons for side effects

The LNG-IUS releases levonorgestrel, a hormone, into the uterus, which helps to thin the uterine lining and reduce bleeding. However, this hormone can also have effects throughout the body, which can lead to a variety of side effects.

Common side effects

Amenorrhea

Amenorrhea, the absence of menstruation, can occur with the use of the LNG-IUS. 15 A meta-analysis reported that amenorrhea occurred more frequently in patients treated with the LNG-IUS compared to thermal balloon ablation at the 24-month follow-up. 13 A multicenter observational cohort study in Chinese women suggested that the LNG-IUS may be associated with amenorrhea.

Bleeding changes

Changes in bleeding patterns, such as increased bleeding, decreased bleeding, or changes in menstrual cycle, can occur with the use of the LNG-IUS. 13 A multicenter observational cohort study in Chinese women suggested that the LNG-IUS may be associated with a different bleeding pattern compared to the copper intrauterine device (Cu-IUD) inserted immediately after abortion.

Abdominal pain

Abdominal pain or back pain can occur with the use of the LNG-IUS. 8 Pain and bleeding were reported as side effects of the LNG-IUS but it was found that the device is safe to use among nulligravidas and adolescents.

Headache

Headaches can occur with the use of the LNG-IUS.

Nausea

Nausea and vomiting can occur with the use of the LNG-IUS.

Weight gain

Weight gain can occur with the use of the LNG-IUS.

Mood changes

Mood changes, such as depression or irritability, can occur with the use of the LNG-IUS.

Other side effects

Other side effects can occur with the use of the LNG-IUS. Consult your doctor if you experience any side effects.

Side effect management

Amenorrhea

If you are concerned about amenorrhea, talk to your doctor. They may recommend removing the LNG-IUS or switching to a different contraceptive method.

Bleeding changes

If you are concerned about changes in bleeding patterns, talk to your doctor. They may prescribe medication to reduce bleeding or recommend removal of the LNG-IUS.

Abdominal pain

If you experience severe abdominal pain, talk to your doctor. They may prescribe pain medication or recommend removal of the LNG-IUS.

Headache

If you experience severe headaches, talk to your doctor. They may prescribe headache medication.

Nausea

If you experience severe nausea, talk to your doctor. They may prescribe anti-nausea medication.

Weight gain

If you are concerned about weight gain, talk to your doctor. They may advise you on diet and exercise.

Mood changes

If you are concerned about mood changes, talk to your doctor. They may prescribe medication to improve depression or irritability or recommend counseling.

Comparison of research studies

Similarities of research studies

Many studies have shown that the LNG-IUS is an effective contraceptive method. It has also been shown to be effective in the treatment of heavy menstrual bleeding.

Differences of research studies

The types and severity of side effects associated with the LNG-IUS vary across studies. For example, 15 found that amenorrhea occurred more frequently in patients treated with the LNG-IUS, while 13 found that there may be a difference in bleeding patterns. This could be due to differences in research methods or populations studied.

Things to keep in mind when applying research to real life

The LNG-IUS is an effective method for contraception and treatment of heavy menstrual bleeding, but it can cause side effects. Before inserting the LNG-IUS, talk to your doctor to understand the benefits and risks and decide if it's right for you. After the LNG-IUS is inserted, it is important to see your doctor regularly to monitor your health.

Current research limitations

There is still a lack of research on the LNG-IUS. Further research is needed, particularly on the long-term effects and rare side effects.

Future directions for research

Further research is needed on the long-term effects and rare side effects of the LNG-IUS. Research is also needed to find ways to reduce the side effects of the LNG-IUS.

Conclusion

The LNG-IUS is an effective method for contraception and treatment of heavy menstrual bleeding, but it can cause side effects such as amenorrhea and changes in bleeding patterns. Before using the LNG-IUS, talk to your doctor to understand the benefits and risks and decide if it's right for you. After the LNG-IUS is inserted, it is important to see your doctor regularly to monitor your health.

Literature analysis of 20 papers
Positive Content
18
Neutral Content
1
Negative Content
1
Article Type
4
1
1
2
20
1.

The influence of Microgynon and Diane-35, two sub-fifty ovulation inhibitors, on voice function in women.

Author: WendlerJ, SiegertC, SchelhornP, KlingerG, GurrS, KaufmannJ, AydinlikS, BraunschweigT

The study investigated the potential voice-related side effects of two oral contraceptives, Diane-35 and Microgynon, in 91 patients over a year. No significant side effects on voice function were observed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

The LNG-IUS study on adenomyosis: a 3-year follow-up study on the efficacy and side effects of the use of levonorgestrel intrauterine system for the treatment of dysmenorrhea associated with adenomyosis.

Author: ShengJie, ZhangWei Yuan, ZhangJian Ping, LuDan

Improved satisfaction
Reduced dysmenorrhea
Abdominal pain
Ovarian cysts
Weight gain

The LNG-IUS appears to be an effective method in alleviating dysmenorrhea associated with adenomyosis during 3 years.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Subendometrial microvascularization and uterine artery blood flow in IUD-induced side effects (levonorgestrel intrauterine system and copper intrauterine device).

Author: JiménezMirela F, VetoriDaniela, FagundesPaulo A P, de FreitasFernando M, Cunha-FilhoJoão S L

Therapeutic treatments
Understand IUD effects

This study quantified subendometrial microvascularization and uterine artery blood flow in patients using intrauterine devices (IUDs). The findings contribute to understanding the vascular changes associated with IUD-induced side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Efficacy, acceptability and side effects of the levonorgestrel intrauterine system for menorrhagia.

Author: KriplaniA, SinghB M, LalS, AgarwalN

Menorrhagia treatment
Amenorrhea
Device expulsion

The levonorgestrel-releasing intrauterine system (LNG-IUS) was found to be an effective and well-accepted option for the medical management of menorrhagia. In a prospective, open, nonrandomized clinical trial, 77.7% of patients experienced a cure at 3 months, and all patients were cured at 36 months. The LNG-IUS significantly decreased the mean number of bleeding days and subjective blood loss, and increased hemoglobin concentration. The most common side effect was intermenstrual spotting.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Compare the Efficacy of Dienogest and the Levonorgestrel Intrauterine System in Women with Adenomyosis.

Author: GuoWeina, LinYuchen, HuSijian, ShenYi

Pain relief
Uterine volume control

Dienogest (DNG) and levonorgestrel intrauterine system (LNG-IUS) are both effective in improving pain associated with adenomyosis. DNG demonstrates continuous pain relief and effectively controls uterine volume growth, making it a more favorable option compared to LNG-IUS.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Comparison of the effect of levonorgestrel-intrauterine system with or without oral megestrol acetate on fertility-preserving treatment in patients with atypical endometrial hyperplasia: A prospective, open-label, randomized controlled phase II study.

Author: XuZhiying, YangBingyi, ShanWeiwei, LiaoJiongbo, ShaoWenyu, WuPengfei, ZhouShuang, NingChengcheng, LuoXuezhen, ZhuQin, ZhangHongwei, MaFenghua, GuanJun, ChenXiaojun

Less side effects with LNG-IUS
Underpowered study

This randomized controlled trial compared the efficacy of levonorgestrel-intrauterine system (LNG-IUS) with or without oral megestrol acetate (MA) versus MA alone for atypical endometrial hyperplasia (AEH). There was no significant difference in complete response rate or other secondary endpoints between the groups. Further studies are needed with a larger sample size to confirm these findings.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Comparing levonorgestrel intrauterine system with hysteroscopic niche resection in women with postmenstrual spotting related to a niche in the uterine cesarean scar: a randomized, open-label, controlled trial.

Author: ZhangJian, ZhuChenfeng, YanLi, WangYang, ZhuQian, HeChuqing, HeXiaoqing, JiSifan, TianYuan, XieLi, LiangYan, XiaWei, MolBen W, HuirneJudith A F

Reduced pain
Reduced spotting

This randomized controlled trial compared the effectiveness of a 52-mg levonorgestrel intrauterine system with hysteroscopic niche resection in reducing niche-related postmenstrual spotting after cesarean delivery. While the levonorgestrel intrauterine system was not more effective than hysteroscopic niche resection at 6 months, it showed superior reduction in spotting from 9 months onward and reduced the absolute number of spotting days and pelvic pain from 6 months onward.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Intrauterine device use is safe among nulligravidas and adolescent girls.

Author: BahamondesM Valeria, BahamondesLuis

Contraception
Unplanned pregnancy prevention
Bleeding
Expulsion rate
Pain

This review discusses the safety and efficacy of intrauterine devices (IUDs) as contraceptives in nulligravidas and adolescent girls, highlighting their effectiveness and potential side effects. The review emphasizes the importance of IUDs in reducing unplanned pregnancies among these populations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Levonorgestrel-releasing intrauterine system for endometrial hyperplasia.

Author: MittermeierTheresa, FarrantCharlotte, WiseMichelle R

EH treatment

The levonorgestrel-intrauterine system (LNG-IUS) is an alternative method of administration of progestogen for endometrial hyperplasia (EH) that may have advantages over non-intrauterine progestogens.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Experiences With the Levonorgestrel Intrauterine System Among Clients, Providers, and Key Opinion Leaders: A Mixed-Methods Study in Nigeria.

Author: EvaGillian, NandaGeeta, RademacherKate, MackayAnna, NegeduOmaye, TaiwoAnne, Dal SantoLeila, SalehMariya, PalmerLucky, BrettTracey

Contraception
Heavy bleeding treatment

The LNG IUS is a very effective contraceptive method that also has noncontraceptive health benefits, such as treating heavy menstrual bleeding. In 2016, Marie Stopes International Organisation Nigeria (MSION) expanded LNG IUS provision through training and support to 9 mobile outreach teams, 105 social franchise clinics, and 20 public-sector providers in 17 states. Information about the LNG IUS was included in awareness-raising materials, and community mobilizers provided information on the LNG IUS alongside other voluntary family planning methods.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

11.

Women's preferences for the levonorgestrel intrauterine system versus endometrial ablation for heavy menstrual bleeding.

Author: van den BrinkMarian J, BeelenPleun, HermanMalou C, ClaassenNathalie J J, BongersMarlies Y, GeominiPeggy M, van der SteegJan Willem, van den WijngaardLotte, van WelyMadelon

Patient satisfaction

This study explores women's preferences for treatment of heavy menstrual bleeding. It aims to determine if women prefer levonorgestrel intrauterine system or endometrial ablation and the relative importance of various treatment characteristics.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Bleeding pattern difference between levonorgestrel intrauterine system and copper intrauterine devices inserted immediately post-abortion: a multicenter, prospective, observational cohort study in Chinese women.

Author: ChenXiaoning, LiQianxi, WangXiaoye, ChenJing, LvWen, ShiBin, WangHong, LuoJianru, LiJian

High satisfaction
Less dysmenorrhea
Reduced bleeding
Amenorrhea
Oligomenorrhea

The levonorgestrel intrauterine system (LNG-IUS) was found to be more effective than the copper intrauterine device (Cu-IUD) in reducing bleeding days and dysmenorrhea after abortion, with a similar safety profile.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

The effectiveness of the levonorgestrel intrauterine system in obese women with heavy menstrual bleeding.

Author: ShawValentina, VandalAlain C, CoomarasamyChristin, EkeromaAlec J

Improved quality of life
Reduced menstrual bleeding

The levonorgestrel intrauterine system (LNG-IUS) was effective in treating heavy menstrual bleeding in 67% of obese women over a 12-month period, leading to a reduction in bleeding and improvements in quality of life.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

16.

Adolescent Experiences With Intrauterine Devices: A Qualitative Study.

Author: SchmidtElizabeth O, JamesAimee, CurranK Michele, PeipertJeffrey F, MaddenTessa

Effective contraception
Bleeding irregularities
Pain

Adolescents chose IUDs for effectiveness, duration, convenience, and potential bleeding changes. Bleeding and pain contributed to discontinuation. Counseling should include these aspects and anticipatory guidance about side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Acute urticaria as a side effect of the Mirena® (levonorgestrel-releasing intrauterine system): a case report.

Author: ChenXiangjuan, WuXueqing, ZhuHaiyan

Urticaria

A 27-year-old woman developed acute urticaria 2 hours after Mirena® implantation, which resolved after the device was removed. This case highlights the potential for allergic reactions to Mirena® implantation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

An update on the pharmacological management of endometriosis.

Author: StreuliIsabelle, de ZieglerDominique, SantulliPietro, MarcellinLouis, BorgheseBruno, BatteuxFrédéric, ChapronCharles

Endometriosis treatment

Endometriosis is a common disease affecting women in their reproductive years. This review discusses different treatment options for endometriosis, including medical and surgical treatments. Commonly used medications include non-steroidal anti-inflammatory drugs, GnRH agonists, androgen derivatives, combined oral contraceptive pills, progestogens, and the levonorgestrel intrauterine system.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Effects of levonorgestrel-releasing intrauterine system and T380A intrauterine copper device on dysmenorrhea and days of bleeding in women with and without adenomyosis.

Author: KelekciSefa, KelekciKiymet Handan, YilmazBulent

Contraception
Dysmenorrhea improvement
Menstrual bleeding improvement
Acne

The levonorgestrel intrauterine system (LNG-IUS) is an effective treatment for adenomyosis-associated heavy menstrual bleeding and dysmenorrhea. It also has significantly fewer side effects than the Copper T380A IUD, except for acne.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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