Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study

Suhonen, Satu; Haukkamaa, Maija; Jakobsson, Tell; Rauramo, Ilkka

doi:10.1016/j.contraception.2003.11.008

Cited by 201 publications

(174 citation statements)

References 21 publications

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“…The 1-year amenorrhea rate of 18.6% for the entire ACCESS IUS cohort, which included women who had been using a LNG IUS in the month prior to enrollment, corroborates the historic rate. Small studies (200 or fewer subjects) have reported varying rates of 11% to 26% [10][11][12]. Most importantly, our findings demonstrate that the rate among new LNG 52 mg IUS users varies by participant characteristic from 13% to 19% and is most dependent on the number of days of menstrual bleeding reported at baseline.…”

Section: Discussionmentioning

confidence: 60%

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Amenorrhea rates and predictors during 1 year of levonorgestrel 52 mg intrauterine system use

et al. 2018

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Objective: The objective was to evaluate amenorrhea patterns and predictors of amenorrhea during the first year after levonorgestrel 52 mg intrauterine system (IUS) placement. Study design: This cohort analysis includes 1714 nulliparous and parous women who received a Liletta® levonorgestrel 52 mg IUS in a multicenter trial to evaluate efficacy and safety for up to 8 years. Participants maintained a daily diary with bleeding information. We assessed bleeding patterns in 90-day intervals; amenorrhea was defined as no bleeding or spotting in the preceding 90 days. We employed multivariable regression to identify predictors of amenorrhea at 12 months. The predictor analysis only included women not using a levonorgestrel IUS in the month prior to study enrollment. Results: In the month before enrollment, 148 and 1566 women, respectively, had used and not used a levonorgestrel IUS. Prior users averaged 50±19 months of use before IUS placement; 38.4% of these women reported amenorrhea at 12 months. Amenorrhea rates for non-prior-users at 3, 6, 9 and 12 months were 0.2%, 9.1%, 17.2% and 16.9%, respectively. During the first 12 months, 29 (1.7%) women discontinued for bleeding irregularities; no women discontinued for amenorrhea. The only significant predictor of amenorrhea at 12 months was self-reported baseline duration of menstrual flow of fewer than 7 days vs. 7 or more days (18.2% vs. 5.2%, adjusted odds ratio 3.70 [1.69, 8.07]). We found no relationships between 12-month amenorrhea rates and age, parity, race, body mass index, baseline flow intensity or hormonal contraception use immediately prior to IUS placement. Conclusions: Amenorrhea rates during the first year of levonorgestrel 52 mg IUS use are similar at 9 and 12 months. Amenorrhea at 12 months is most common among women with shorter baseline duration of menstrual flow. Implications statement: This information provides more data for clinicians when counseling women about amenorrhea expectations, especially since women seeking a levonorgestrel 52 mg IUS for contraception are different than women desiring treatment for heavy menstrual bleeding. Amenorrhea at 12 months is most common among women with shorter baseline duration of menstrual flow.

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Section: Discussionmentioning

confidence: 60%

“…Still, amenorrhea is not the only pattern of decreased flow women experience with LNG 52 mg IUS use. Most women who are not amenorrheic experience light bleeding or spotting, a pattern considered favorable by LNG 52 mg IUS users [10,11].…”

Section: Discussionmentioning

confidence: 99%

Amenorrhea rates and predictors during 1 year of levonorgestrel 52 mg intrauterine system use

et al. 2018

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“…Nonetheless, current data suggest that IUDs are generally well tolerated in young women and that continuation and satisfaction rates are high. [71][72][73][74] Adolescent-specific data are limited on acceptability and use of IUDs for contraception; however, recent studies are promising, suggesting 1-year continuation rates of 75% or greater. [75][76][77][78] The data on levonorgestrel IUD use for medical indications in adolescents reveal improvement in dysmenorrhea and heavy menses.…”

Section: Intrauterine Contraceptionmentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

244

133

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A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians’ long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions.

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“…58 Another concern is that more than half of young nulliparous women report moderate to severe pain with insertion. 59,60 Nonetheless, studies demonstrate IUD continuation rates in adolescents that exceed those with other hormonal methods and effective use of the levonorgestrel IUD for menstrual suppression in adolescent patients with complex medical conditions. 61-67…”

Section: Iudsmentioning

confidence: 99%

Contraception for Adolescents

Braverman¹,

Adelman²,

Alderman³

et al. 2014

Pediatrics

307

107

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Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report.

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Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study

Cited by 201 publications

References 21 publications

Amenorrhea rates and predictors during 1 year of levonorgestrel 52 mg intrauterine system use

Amenorrhea rates and predictors during 1 year of levonorgestrel 52 mg intrauterine system use

Contraception for Adolescents

Contraception for Adolescents

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