Effect of levonorgestrel-releasing intrauterine device on hormonal profile and menstrual pattern after long-term use

Xiao, Biao; Zeng, Tao; Wu, Shangchun; Sun, Hongchen; Xiao, Na

doi:10.1016/0010-7824(95)00102-g

Cited by 68 publications

(41 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…42 The LNG-IUD appears to have minimal effects on ovulation and breast milk production and does not markedly affect serum levels of E2, progesterone, or luteinizing hormone. 42,43 However, LNG is one of the most potent progestins and has high binding affinity for PRs. 44 In addition, LNG strongly binds SHBG and lowers serum SHBG levels.…”

Section: Aub Caused By Anatomic Abnormalitiesmentioning

confidence: 99%

“…44 In addition, LNG strongly binds SHBG and lowers serum SHBG levels. 43 Use of the LNG-IUD has been associated with increased incidence of gallbladder disease (relative risk, 1.5), hypertension (relative risk, 1.8), headache, malaise, weight change, anxiety, depression, arthropathies, upper-limb neuropathies, and minor visual disturbances. 45 Thus, although some reproductive functions appear to be unaffected, LNG administered via an IUD does seem to have systemic effects.…”

Section: Aub Caused By Anatomic Abnormalitiesmentioning

confidence: 99%

See 1 more Smart Citation

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Bakkum-Gamez

Laughlin

Jensen

et al. 2011

Mayo Clinic Proceedings

View full text Add to dashboard Cite

). © 2011 Mayo Foundation for Medical Education and ResearchB reast cancer is the leading cause of cancer death in women in the United States who are aged 20 to 59 years. 1 In 2010, an estimated 207,090 new cases of breast cancer were identified in the United States. 2 Although breast cancer risk increases with age, approximately 35% of breast cancers occur during the reproductive and perimenopausal years. 3 The 5-year relative survival rate for women of all ages with breast cancer diagnosed between 1999 and 2005 is 89%. 3 Of the premenopausal breast cancers diagnosed, approximately 58% are both estrogen receptor (ER) and progesterone receptor (PR) positive, 6% are ER positive only, 17% are PR positive only, and 20% are both ER and PR negative. 4 The management and treatment of breast cancer in premenopausal women can affect menstruation, reproduction, and gynecologic health. Breast cancer treatment can have a marked affect on fertility in women who have delayed childbearing and have fewer remaining reproductive years. Among premenopausal women with breast cancer, more than 50% wish to retain their fertility. 5 AUB = abnormal uterine bleeding; E2 = estradiol; EA = endometrial ablation; EC = endometrial cancer; ER = estrogen receptor; FDA = Food and Drug Administration; GnRH = gonadotropin-releasing hormone; IUD = intrauterine device; LNG = levonorgestrel; NSAID = nonsteroidal anti-inflammatory drug; PR = progesterone receptor; SHBG = sex hormone-binding globulin gynecologic issues and conditions are prevalent in reproductive-age women. In the general population, more than 30% of reproductive-age women fulfill criteria for the diagnosis of menorrhagia, 6 25% have symptomatic fibroids, 7 and nearly 67% have an underlying uterine disorder with potential to cause abnormal uterine bleeding (AUB). 8 Among premenopausal women with breast cancer, management of menstrual disorders, contraception, vasomotor symptoms, and fertility presents a challenge. Common and effective hormonal options are less well studied in this population because of significant concern about recurrence of breast cancer. Herein,we present the challenges and discuss management options for young women with breast cancer who present with various common gynecologic conditions.Articles for this review were identified by searching the PubMed database with no date limitations. PREMENoPAUSAL SEx STERoIDS AND THEIR PHARMACoLoGyPhysiologically, premenopausal women with regular cycles have cyclic variation in levels of estradiol (E2) (15-350 pg/ mL [to convert to pmol/L, multiply by 3.671]) and progesterone (0.2-27 ng/mL [to convert to nmol/L, multiply by 3.18]). These "free" (unbound) hormones are biologically active and can enter a target cell and activate its receptor.

show abstract

Section: Aub Caused By Anatomic Abnormalitiesmentioning

confidence: 99%

Section: Aub Caused By Anatomic Abnormalitiesmentioning

confidence: 99%

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Bakkum-Gamez

Laughlin

Jensen

et al. 2011

Mayo Clinic Proceedings

View full text Add to dashboard Cite

show abstract

“…Again, these studies are inconsistent with a mechanism that would decrease EC risk through lower ER activity compared to PR. Moreover, the literature provides conflicting evidence regarding variations in serum ovarian steroidhormone levels between IUD users and non-users [60][61][62][63][64] . At this time it is unclear whether IUDs, particularly inert IUDs, lower EC risk through hormonal mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Devices and Endometrial Cancer Risk: A Pooled Analysis of the Epidemiology of Endometrial Cancer Consortium

Felix¹,

Gaudet²,

Vecchia³

et al. 2014

Annals of Epidemiology

View full text Add to dashboard Cite

Intrauterine devices (IUDs), long-acting and reversible contraceptives, induce a number of immunological and biochemical changes in the uterine environment that could affect endometrial cancer (EC) risk. We addressed this relationship through a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We combined individual-level data from 4 cohort and 14 case-control studies, in total 8,801 EC cases and 15,357 controls. Using multivariable logistic regression, we estimated pooled odds ratios (pooled-ORs) and 95% confidence intervals (CIs) for EC risk associated with ever use, type of device, ages at first and last use, duration of use, and time since last use, stratified by study and adjusted for confounders. Ever use of IUDs was inversely related to EC risk (pooled-OR=0.81, 95% CI=0.74-0.90). Compared with never use, reduced risk of EC was observed for inert IUDs (pooled-OR=0.69, 95% CI=0.58-0.82), older age at first use (≥35 years pooled-OR=0.53, 95% CI=0.43-0.67), older age at last use (≥45 years pooled-OR=0.60, 95% CI=0.50-0.72), longer duration of use (≥10 years pooled-OR=0.61, 95% CI=0.52-0.71), and recent use (within 1 year of study entry pooled-OR=0.39, 95% CI=0.30-0.49). Future studies are needed to assess the respective roles of detection biases and biologic effects related to foreign body responses in the endometrium, heavier bleeding (and increased clearance of carcinogenic cells), and localized hormonal changes.

show abstract

“…8 The device causes endometrial atrophy, thickens cervical mucus (preventing sperm penetration) and, in some users, prevents or delays ovulation. It may also prevent implantation, 11,12 and has contraceptive efficacy of 99.8% in typical and perfect use. 13 Apart from a small risk of infection in the first three weeks after insertion, modern devices are not associated with an increased risk of future infertility or pelvic infection.…”

Section: The Levonorgestrel Intrauterine Devicementioning

confidence: 99%

Choosing non-oral, long-acting reversible contraception

Stewart¹,

Bateson²

2016

Aust Prescr

View full text Add to dashboard Cite

SUMMARYLong-acting reversible contraception methods include the copper and hormonal intrauterine devices, the contraceptive implant and the contraceptive injection. These should be discussed with women considering their options for contraception.These methods are more effective at reducing unintended pregnancy than oral contraceptives and have a good safety profile with few contraindications.The progestogen-only intrauterine device can be used to manage heavy menstrual bleeding.

show abstract

Effect of levonorgestrel-releasing intrauterine device on hormonal profile and menstrual pattern after long-term use

Cited by 68 publications

References 11 publications

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Intrauterine Devices and Endometrial Cancer Risk: A Pooled Analysis of the Epidemiology of Endometrial Cancer Consortium

Choosing non-oral, long-acting reversible contraception

Contact Info

Product

Resources

About