The levonorgestrel-releasing intrauterine system 52 mg as a contraceptive versus a therapeutic: essential differences and perspectives

Abstract

Background

It is 100 years since the discovery of oestrogen and nearly that since the discovery of progesterone. It is over 50 years since the concept of using intrauterine progesterone. Ten years after its synthesis, the research using levonorgestrel as an intrauterine agent was introduced.

Areas covered

The pharmacodynamics and pharmacokinetics of LNG-IUSs and the LNG-IUS 52 mg in particular explain why intrauterine LNG is so highly effective for contraception. When intrauterine LNG is used therapeutically it should ideally be based on clinical monitoring of the pathology being treated rather than a fixed time period While the LNG-IUS 52 mg is probably required for most medical conditions, consideration should be given for using the LNG-IUS 13.5 mg for hyperplasia and endometrial protection during oestrogen therapy and for older women who appear more prone to a low rate of LNG induced breast cancer, although there is not yet an official indication for this.

Conclusion

The desire for fertility control, therapy for various genital pathological conditions and reduction of repeated endometrial decidualization and inflammatory breakdown and its consequences, and menopausal problems can be aided by intrauterine LNG. This review explains how a contraceptive also became a WHO listed essential medicine.

SHORT CONDENSATION

There are significant differences at many levels in the use of intrauterine levonorgestrel for contraception when compared to using it as a therapeutic.

摘要

背景：雌激素被发现已有100年, 孕激素被发现也将近100年。宫内应用孕激素的概念已经有50多年的历史了。本文介绍了左炔诺孕酮合成十年后作为宫内用药的研究进展。

涉及领域：LNG- IUS, 尤其是LNG- IUS 52 mg的药效学和药代动力学揭示了为什么宫内LNG对避孕如此有效。当左炔诺孕酮宫内释放系统用于治疗时, 理想情况下应基于对病情治疗的实时临床监测, 而不是固定的治疗时长。虽然大多数临床状况可能需要52毫克的LNG- IUS, 但应考虑在雌激素治疗期间应用13.5毫克的LNG- IUS用于子宫内膜增生和子宫内膜保护, 以及对于年龄较大的女性, 她们似乎更容易患LNG诱发的乳腺癌, 尽管目前还没有正式的指征。

结论：左炔诺孕酮宫内释放系统可有助于节育、治疗各种生殖病理状况, 减少子宫内膜反复蜕膜化、炎症分解及其后果, 以及绝经症状。本综述阐释了一种避孕药具如何成为世卫组织列出的基本治疗药物。

简短总结

应用子宫内左炔诺孕酮避孕与将其用作治疗在许多方面上存在显著差异。

Keywords:

• Intrauterine
• levonorgestrel
• contraception
• therapy
• PALM-COEIN

Disclosure statement

No potential conflict of interest was reported by the author.