Endometrial Morphology of Women Using A d-Norgestrel-Releasing Intrauterine Device

Nilsson, Carl Gustaf; Luukkainen, Tapani; Arko, Harri

doi:10.1016/s0015-0282(16)43212-7

Cited by 95 publications

(6 citation statements)

References 7 publications

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“…Endometrial changes were also evaluated with devices releasing either 20 or 40 μg/day, observing a uniform suppression of the endometrium with glandular atrophy and the decidualization of the stroma [ 44 ].…”

Section: Levonorgestrel-releasing Intrauterine Systemsmentioning

confidence: 99%

“…Locally released LNG has a profound effect on the endometrium: as already mentioned, back in 1978, changes in the endometrium were evaluated with devices releasing either 20 or 40 μg/day, observing a uniform suppression of the endometrium [ 44 ]. Under the influence of locally delivered LNG, there is a thinning of the mucosa to about 1–3 mm.…”

Section: Use In Abnormal Uterine Bleedingmentioning

confidence: 99%

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Utility of the Levonorgestrel-Releasing Intrauterine System in the Treatment of Abnormal Uterine Bleeding and Dysmenorrhea: A Narrative Review

Bianchi

Guo

Habiba

et al. 2022

JCM

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Introduction: We undertook a literature review of the use of levonorgestrel-releasing intrauterine devices when utilized for heavy menstrual bleeding and/or dysmenorrhea. Methods: A narrative review of articles in the Scopus and Medline databases was conducted. Results: A number of options exist for the management of both abnormal uterine bleeding (AUB) and dysmenorrhea, and evidence is accumulating that the insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) represents a useful option for their long-term treatment. The idea of using a progestogen released in utero was initially conceived to achieve long-term contraception, but it was quickly found that these systems could be utilized for a number of therapeutic applications. The first device to be made commercially available, Progestasert, was withdrawn from the market because, in the event of contraceptive failure, it caused a disproportionate percentage of extrauterine pregnancies. On the other hand, the LNG-IUS continues to be successfully utilized in its various variants, releasing 20, 13, or 8 μg/day. These devices have a respective duration of action of 7 (possibly 8), 5, and 3 years, and there exist versions of frameless systems affixed to the myometrium of the uterine fundus. In the present review, following a brief description of the major causes of AUB and dysmenorrhea, the molecular bases for the use of the LNG-IUS are summarized. This is followed by a compendium of its use in AUB and dysmenorrhea, concluding that the insertion of the system improves the quality of life, reduces menstrual blood loss better than other medical therapies, and decreases the extent of dysmenorrhea and pelvic pain. In addition, there is no evidence of a significant difference in these outcomes when the use of the LNG-IUS was compared with improvements offered by endometrial ablation or hysterectomy. Possibly, the most important mechanism of action of the system consists of its ability to induce amenorrhea, which effectively eliminates heavy bleeding and dysmenorrhea. However, no method is ideal for every woman, and, in the case of the LNG-IUS, younger age and severe dysmenorrhea seem to be associated with a higher risk of discontinuation. Conclusion: The higher-dose LNG-IUS is a useful tool for HMB and dysmenorrhea in women of all ages. The low cost and ease of use make the LNG-IUS an attractive option, especially when contraception is also desired.

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Section: Levonorgestrel-releasing Intrauterine Systemsmentioning

confidence: 99%

Section: Use In Abnormal Uterine Bleedingmentioning

confidence: 99%

Utility of the Levonorgestrel-Releasing Intrauterine System in the Treatment of Abnormal Uterine Bleeding and Dysmenorrhea: A Narrative Review

Bianchi

Guo

Habiba

et al. 2022

JCM

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“…Locally administered levonorgestrel has a profound e ect on the endometrium, which becomes atrophic and inactive, while ovulation is usually not suppressed . Its e ects are predominantly localised to the endometrium with the high concentrations of levonorgestrel inducing atrophy and pseudodecidualisation (Maruo 2001;Nilsson 1978;Silverberg 1986). The systemic levels following LNG-IUD administration are less than those achieved with therapeutic oral or parenteral doses of progestogens (Du 1999;Fedele 2001;Luciano 1988;Moghissi 1999;Nilsson 1978) hence side e ects should theoretically be less.…”

Section: How the Intervention Might Workmentioning

confidence: 99%

“…Its e ects are predominantly localised to the endometrium with the high concentrations of levonorgestrel inducing atrophy and pseudodecidualisation (Maruo 2001;Nilsson 1978;Silverberg 1986). The systemic levels following LNG-IUD administration are less than those achieved with therapeutic oral or parenteral doses of progestogens (Du 1999;Fedele 2001;Luciano 1988;Moghissi 1999;Nilsson 1978) hence side e ects should theoretically be less. When provided immediately or very soon a er surgical removal or ablation of endometriotic patches, levonorgestrel is expected to suppress the regeneration of endometriosis (Tanmahasamut 2012).…”

Section: How the Intervention Might Workmentioning

confidence: 99%

Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery

Gibbons

Georgiou

Cheong

et al. 2021

Cochrane Database of Systematic Reviews

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“…Assim como ocorre com os outros métodos anticoncepcionais contendo somente progestógenos, os mecanismos do sangramento anormal não são bem conhecidos. Entretanto, sabe-se que o SIU-LNG induz a uma rápida e dramática diferenciação do endométrio (Nilsson et al, 1978;Silverberg et al, 1986). Estas mudanças são consistentes com a transformação mediada pela progesterona, observada durante a fase secretória do ciclo menstrual normal e na gestação.…”

Section: Introductionunclassified

Quimiocinas endometriais, celulas natural killer uterinas e mastocitos em usuarias do sistema intra-uterino liberador de levonorgestrel com e sem sangramento uterino no terceiro ano de uso

Pinto¹,

Petta²

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Dedico esta tese... ... aos meus pais, Nestor e Elenilce, pelo exemplo de disciplina, caráter, dignidade e amor. ...ao meu marido Rovilson, pela paciência e compreensão, pelo amor e carinho, e pelo significado em minha vida. ...aos meus filhos Guilherme e Maria Eduarda, pela alegria e pelos momentos mágicos de nossas vidas. ...à minha irmã Camila , pelo carinho, apoio e companheirismo. v Agradecimentos Ao Prof. Dr.Carlos Alberto Petta, pelo apoio e incentivo na realização deste estudo. Ao Prof. Dr. Luis Bahamondes, grande incentivador e exemplo de profissionalismo. À Dra. Lois Salamonsen, grande pesquisadora, pela paciência e desinteressada ajuda durante a realização deste trabalho no seu laboratório em Melbourne, Austrália. À grande companheira Jin Zhang, pela atenção e carinho durante a realização da parte prática deste trabalho.

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Endometrial Morphology of Women Using A d-Norgestrel-Releasing Intrauterine Device

Cited by 95 publications

References 7 publications

Utility of the Levonorgestrel-Releasing Intrauterine System in the Treatment of Abnormal Uterine Bleeding and Dysmenorrhea: A Narrative Review

Utility of the Levonorgestrel-Releasing Intrauterine System in the Treatment of Abnormal Uterine Bleeding and Dysmenorrhea: A Narrative Review

Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery

Quimiocinas endometriais, celulas natural killer uterinas e mastocitos em usuarias do sistema intra-uterino liberador de levonorgestrel com e sem sangramento uterino no terceiro ano de uso

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