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

Figures & data

Figure 1 The levonorgestrel-releasing intrauterine system device.

Figure 2 Comparison of plasma concentrations of different contraceptives containing levonorgestrel (LNG). From data of Nilsson et al¹¹ and Diaz et al.¹²

Abbreviations: LNG-IUS, levonorgestrel-releasing intrauterine system; COC, combined oral contraceptives; POP, progesterone only pills.

Figure 3 Typical use versus perfect use (first year failure rates). LNG-IUS provides highly effective contraception that is not user-dependent. From data of Trussell.¹²⁴

Abbreviations: LNG-IUS, levonorgestrel-releasing intrauterine system; OCPs, oral contraceptive pills.

Table 1 WHO medical eligibility criteria contraindications to levonorgestrel-releasing intrauterine system insertion

(Category 4 or risk is unacceptable)

Current pregnancy Current purulent cervicitis or pelvic infection (delay insertion until treatment is complete) Immediate post-septic abortion Current malignant gestational trophoblastic disease Current breast cancer Untreated cervical cancer Untreated endometrial cancer Unexplained vaginal bleeding Distorted uterine cavity (any congenital or acquired abnormality interfering with IUD insertion, including uterine fibroids) Known pelvic tuberculosis

Data from World Health Organization 2004.⁵

Figure 4 The levonorgestrel-releasing intrauterine system can be easily identified on transvaginal ultrasound. Note the shadowing caused by the stem of the device (arrows) in the anterior-posterior plane (panel A), and the T bar seen in the transverse orientation (panel B).

NilssonCGLahteenmakiPRobertsonDNLuukkainenTPlasma concentrations of levonorgestrel as a function of the release rate of levonorgestrel from medicated intra-uterine devicesActa Endocrinol1980933803847376797

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DiazSPavezMMirandaPJohanssonEDBCroxattoHBLong-term follow-up of women treated with Norplant implantsContraception1987355515673117490

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TrussellJContraceptive failure in the United StatesContraception200470899615288211

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World Health OrganizationImproving Access to Quality Care in Family Planning Medical Eligibility Criteria for Contraceptive Use3rd edGenevaWHO2004

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