Factors affecting the spontaneous expulsion of the levonorgestrel-releasing intrauterine system

Youm, Jina; Lee, Hyun Ju; Kim, Seul Ki; Kim, Hoon; Jee, Byung Chul

doi:10.1016/j.ijgo.2014.02.017

Cited by 34 publications

(23 citation statements)

References 19 publications

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“…The women in this study had sociodemographic and reproductive characteristics commonly found in studies evaluating long-term contraceptive methods, as the LNG-IUS. 10,16,17 At the time of LNG-IUS insertion, their mean age was 35 (± 8) years old and had between 8-11 years of schooling. A study that followed 61,448 patients over seven years in six European countries recorded a mean age of 37.4 years among women who opted for the LNG-IUS.…”

Section: Discussionmentioning

confidence: 99%

Indications and reasons for discontinuing the levonorgestrel-releasing intrauterine system (LNG-IUS)

Pires

Souza

Dantas

et al. 2020

Rev. Bras. Saude Mater. Infant.

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Objectives: to identify the main indications and reasons for discontinuing the use of the Levonorgestrel-Releasing Intrauterine System (LNG-IUS). Methods: a cross-sectional study was carried out from medical records of 327 women who used the LNG-IUS 52mg between January 2011 and December 2016 at a public hospital in the Northeast of Brazil. Results: the main indications for the use of the LNG-IUS were: contraception (32.7%), myoma/metrorrhagia (28.7%) and endometriosis/pelvic pain (22.3%). Of the 327 women, 68 (20.8%) had discontinued using the device. The most frequent reasons for discontinuation were: expulsion (9.2%), LNG-IUS expiration (3.7%), bleeding (2.4%) and pain (1.5%). Most patients had no difficulty in the insertion and did not require anesthesia/sedation. Among the 30 women who expelled the device, 17 (56.7%) had used it for metrorrhagia and myoma, 8 (26.7%) for contraception, and 5 (16.6%) for endometriosis/pelvic pain. Conclusions: the LNG-IUS is a well-accepted contraceptive method, with therapeutic applications for some gynecological conditions and a low expulsion rate.

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Section: Discussionmentioning

confidence: 99%

Indications and reasons for discontinuing the levonorgestrel-releasing intrauterine system (LNG-IUS)

Pires

Souza

Dantas

et al. 2020

Rev. Bras. Saude Mater. Infant.

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“…Youm et al. 15 found that the 3-year expulsion rate of Mirena was 11.1% for patients with a large uterus and that it increased menstruation. Zhang et al.…”

Section: Discussionmentioning

confidence: 99%

“…14 We found that implantation of Mirena significantly reduced the degree of dysmenorrhea. Youm et al 15 found that the 3-year expulsion rate of Mirena was 11.1% for patients with a large uterus and that it increased menstruation. Zhang et al 16 noted that for patients with adenomyosis with a large uterus (larger than that at 3 months of pregnancy), the combination of GnRH-a and LNG-IUS could significantly reduce the a P < 0.001 when compared with Groups 1, 2, 4, 5, and 6; b P < 0.001 when compared with Groups 1 to 5; *P < 0.05; **P < 0.01; ***P < 0.001…”

Section: Discussionmentioning

confidence: 99%

Drug therapy for adenomyosis: a prospective, nonrandomized, parallel-controlled study

Ding

Zhang

et al. 2018

J Int Med Res

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ObjectiveTo provide novel insights into the clinical treatment of adenomyosis.MethodsTwo hundred patients with adenomyosis were enrolled in this prospective, nonrandomized, parallel-controlled study with a 1-year follow-up in our hospital. Group 1 was treated with 3.75 mg leuprorelin acetate (LA) (n = 40), Group 2 was treated with 1.88 mg LA (n = 40), Group 3 underwent Mirena implantation (n = 40), Group 4 underwent Mirena implantation after treatment with 3.75 mg LA (n = 40), Group 5 underwent Mirena implantation after treatment with 1.88 mg LA (n = 20), and Group 6 received San-Jie-Zhen-Tong capsules alone (n = 20). Uterine volume, pain, cancer antigen 125 level, ovary function, adverse effects, and Mirena expulsion were evaluated.ResultsThe uterine volume and pain scores were lower in the groups treated with 1.88 than 3.75 mg LA, but the lower dose was associated with significantly fewer hot flashes and sweating. The 1-year Mirena expulsion rate was higher in Group 3 than in Groups 4 and 5 (10.00% vs. 3.33%, respectively). Costs were significantly higher in Groups 1 and 4 than in Groups 2 and 5.ConclusionAdministration of 1.88 mg LA may be an alternative therapy for Asian patients with adenomyosis. The combination of LA and Mirena could enhance the therapeutic effect.Registration number: ChiCTR-IPR-15005971

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“…The results showed that almost 50% of the expulsions occurred in the first 12 months after insertion; one explanation for this could be that IUCs were inserted in a low position. There is evidence that in users of T‐shaped IUDs who received the device in a low position, the IUD tends to move upward after insertion . Additionally, previous studies have shown that growth and thinning of the endometrium, assessed by ultrasound, influenced the T‐shaped IUD position in the uterine cavity and that during the first three months of IUD use the device accommodates in the uterine cavity …”

Section: Discussionmentioning

confidence: 99%

Comparison of two cohorts of women who expulsed either a copper‐intrauterine device or a levonorgestrel‐releasing intrauterine system

Simonatto

Bahamondes

Fernandes

et al. 2016

J of Obstet and Gynaecol

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Factors affecting the spontaneous expulsion of the levonorgestrel-releasing intrauterine system

Abstract: Clinicians need to be aware of the risk factors for spontaneous LNG-IUS expulsion because this can lead to a discontinuation of its use.

Cited by 34 publications

References 19 publications

Indications and reasons for discontinuing the levonorgestrel-releasing intrauterine system (LNG-IUS)

Indications and reasons for discontinuing the levonorgestrel-releasing intrauterine system (LNG-IUS)

Drug therapy for adenomyosis: a prospective, nonrandomized, parallel-controlled study

Comparison of two cohorts of women who expulsed either a copper‐intrauterine device or a levonorgestrel‐releasing intrauterine system

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