Levonorgestrel Intrauterine System for Contraception: An Expert Panel Consensus Statement

Abstract

Aim:The primary objective of this consensus document is to develop evidence-based consensus recommendations on the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception in the Indian setting. Background: The unintended pregnancy rate in India is among the highest in the world. Current contraceptive options for women in India include combined or progesterone-only contraceptive pills, vaginal ring, depot medroxyprogesterone acetate, copper intrauterine devices, LNG-IUS, and implants. However, currently, there are no India-specific guidelines/recommendations on the use of LNG-IUS in women. Therefore, an expert panel meeting was convened to arrive at practical recommendations for clinicians on the appropriate use of LNG-IUS. Review results: The panel comprising 15 obstetrics and gynecology experts from India discussed appropriate patient profiles for LNG-IUS and available evidence for the general population and women with comorbidities. The panel thoroughly reviewed the existing literature on contraception and put forth definitive recommendations to be followed on the use of LNG-IUS in the Indian setting. Consensus-based clinical recommendations were developed to serve as a reference for clinicians, regarding the use of LNG-IUS in the general population and women with comorbidities. Conclusion:The use of the LNG-IUS in selected population can ensure contraception and also enhance treatment outcomes. The consensus recommendations given in this document can guide clinicians toward the same in Indian settings. Clinical significance: The LNG-IUS, while being effective for contraception, offers several advantages in terms of reversibility, reduced pelvic infections, etc. Clinicians should carefully select the specific patient profiles/subgroups who would benefit from the use of LNG-IUS.