Thirty years of mirena: A story of innovation and change in women’s healthcare

Gemzell‐Danielsson, Kristina; Kubba, Ali; Caetano, Cecilia; Faustmann, Thomas; Lukkari-Lax, Eeva; Heikinheimo, Oskari

doi:10.1111/aogs.14110

Cited by 19 publications

(8 citation statements)

References 41 publications

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“…22 Also, the benefit regarding bleeding control in women with heavy menstrual bleeding could be a reason for this choice among women with a high BMI, including after bariatric surgery. 23,24 Furthermore, the ENGimplant was more commonly chosen by women with normal weight, a group in which the younger women were concentrated, and it was less commonly chosen by women with obesity. The implant is an underused LARC method in Brazil, with a low prevalence.…”

Section: Discussionmentioning

confidence: 99%

Female body mass index and the selection of a long‐acting reversible contraception for the first time

Frederico

Santos

Ferreira

et al. 2022

Intl J Gynecology & Obste

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Objective: To evaluate Brazilian women with different body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) values who were switching from a short-acting reversible contraceptive (SARC) to a long-acting reversible contraceptive (LARC) method in relationship to the reasons reported for switching and the LARC method chosen. Method:We analyzed retrospective data from 1508 women aged 18-49 years who chose a LARC for the first time. The variables were sociodemographic, BMI, SARC in use, the reason given for switching, the chosen LARC (copper intrauterine device, levonorgestrel (52 mg) intrauterine system or ethyl norgestrel implant), and expectations of the LARC. We used χ 2 , Mann-Whitney, and Kruskal-Wallis tests to compare BMI groups. The significance level adopted was 5%. Results:The obesity group, 320 women (21.2%), reported weight gain (P < 0.000) and fear of pregnancy (P = 0.004) as the most frequent reasons for switching, whereas the normal weight group, 637 women (42.2%), reported more loss of libido (P < 0.000) and other personal complaints (P = 0.002). The IUD was chosen by 851 women (56.6%) and significantly by the largest number of obese women. Conclusion: Women in different BMI categories report different reasons for switching from SARC methods and elect different LARC methods for contraception. K E Y W O R D S body mass index, Brazil, contraception, long-acting reversible contraception How to cite this article: Frederico G, Silva dos Santos PN, Ferreira JM, Bahamondes L, Fernandes A. Female body mass index and the selection of a long-acting reversible contraception for the first time.

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Section: Discussionmentioning

confidence: 99%

Female body mass index and the selection of a long‐acting reversible contraception for the first time

Frederico

Santos

Ferreira

et al. 2022

Intl J Gynecology & Obste

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“…Even though LNG-IUS 52 mg has been proven to be an effective means of reducing AUB, and AUB is one mean point in niche-related symptoms, evidence that LNG-IUS 52 mg can alleviate the niche-related symptoms remains limited. 20 21 Concerning LNG-IUS 52 mg, a retrospective study of Chen et al including six women indicated a positive effect, while Zhang et al found that LNG-IUS 52 mg has little improvement on shortening postmenstrual spotting based on five patients with ING-IUS 52 mg. 22 23 Until now, it is unknown which therapy is most beneficial for patients with niche-related symptoms due to the lack of comparative studies.…”

Section: Introductionmentioning

confidence: 99%

“…LNG-IUS 52 mg has been shown to reduce menstrual blood loss and dysmenorrhea through the suppressive action of levonorgestrel on the endometrium proliferation. Even though LNG-IUS 52 mg has been proven to be an effective means of reducing AUB, and AUB is one mean point in niche-related symptoms, evidence that LNG-IUS 52 mg can alleviate the niche-related symptoms remains limited 20 21. Concerning LNG-IUS 52 mg, a retrospective study of Chen et al including six women indicated a positive effect, while Zhang et al found that LNG-IUS 52 mg has little improvement on shortening postmenstrual spotting based on five patients with ING-IUS 52 mg 22 23.…”

Section: Introductionmentioning

confidence: 99%

Comparing levonorgestrel intrauterine system versus hysteroscopic resection in patients with postmenstrual spotting related to a niche in the caesarean scar (MIHYS NICHE trial): protocol of a randomised controlled trial

Liu

et al. 2021

BMJ Open

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IntroductionRecently, the rate of caesarean sections (CS) worldwide has risen and CS-associated complications such as niche have increased substantially. Until now, evidence-based clinical guidelines for the treatment of niche-related symptoms remain absent. In patients with postmenstrual spotting, it has not been studied if the effect of levonorgestrel 52 mg intrauterine system (LNG-IUS 52 mg) is superior to that of hysteroscopy. This study will answer the question of whether LNG-IUS 52 mg is more effective in improving postmenstrual spotting than hysteroscopic niche resection in women with niche-related spotting at 6 months after randomisation.Methods and analysisThis is a randomised controlled trial. A total of 208 women with postmenstrual spotting related to niche in the caesarean uterine scar of at least 2 mm and residual myometrium of at least 2.2 mm evaluated by MRI will be included. Women desiring to conceive within 1 year, with contraindications for LNG-IUS 52 mg or hysteroscopic surgery will be excluded. After informed consent is obtained, eligible women will be randomly allocated to LNG-IUS 52 mg or hysteroscopic niche resection at 1:1. The primary outcome is the efficacy in reducing postmenstrual spotting at 6 months after randomisation. The secondary outcomes include menstrual pattern, total days of blood loss per month, rate of amenorrhoea, side effects and complications.We will use a Visual Analogue Scale for chronic pelvic pain, urological symptoms and women’s satisfaction (five-point Likert scale).Ethics and disseminationThe study was approved by the local medical ethics committee and by the Institutional Review Board of the International Peace Maternity and Child Health Hospital, Shanghai, China (No. GKLW 2019-08). Participants will sign a written informed consent before participation. The results of this study will be submitted to a peer-reviewed journal for publication.Trial registration numberChiCTR1900025677.

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“…The levonorgestrel 52 mg intrauterine device (IUD) has been commercially available throughout the world for decades, with indications for contraception and heavy menstrual bleeding treatment. 1 A new branded product, Levosert, entered the European market in 2012 and was initially marketed with an inserter requiring two-handed use. Contraception approval was primarily based on a phase-3 study performed in the United States (US) which initially used the original inserter and then transitioned to a redesigned inserter intended for single-handed use.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility study of a single‐handed inserter for levonorgestrel 52 mg intrauterine device placement

Eisenberg,

Schreiber,

Blumenthal

et al. 2023

Repro Female Child Health

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ObjectiveTo assess placement outcomes using a levonorgestrel 52 mg intrauterine device (IUD) inserter designed for single‐handed use.MethodsInvestigators enroled participants 18–45 years to have the IUD inserted using a redesigned inserter with removal 5–15 min after placement. Physicians and participants provided feedback on their insertion experience.ResultsSuccessful placement occurred in 48 of 50 (96.0%) enroled participants. Investigators rated insertion device loading “easy” in 49 (98.0%) and placement “easy” in 44 (88.0%) cases. Cramping pain was reported at insertion by 47 (94.0%) participants, mostly mild (32 [64.0%]) or moderate (11 [22.0%]).ConclusionThe single‐handed inserter is easy to use and results in high rates of insertion success.

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Thirty years of mirena: A story of innovation and change in women’s healthcare

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 19 publications

References 41 publications

Female body mass index and the selection of a long‐acting reversible contraception for the first time

Female body mass index and the selection of a long‐acting reversible contraception for the first time

Comparing levonorgestrel intrauterine system versus hysteroscopic resection in patients with postmenstrual spotting related to a niche in the caesarean scar (MIHYS NICHE trial): protocol of a randomised controlled trial

Feasibility study of a single‐handed inserter for levonorgestrel 52 mg intrauterine device placement

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