Attitudes of Israeli gynecologists towards the levonorgestrel-releasing intrauterine system: a questionnaire survey.
OBJECTIVE
The aim of the study was to examine the current attitudes and practices of gynecologists regarding the use of the levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena, Schering AG, Germany) as a contraceptive device and for the treatment of menorrhagia in the premenopausal period. In addition, physician knowledge of patient satisfaction with the device was evaluated.


METHODS
A written, self-administered questionnaire was given to 300 gynecologists actively employed in gynecological departments and outpatient clinics in urban centers in Israel. The items covered the indications for which the LNG-IUS was prescribed, the estimated rate of use of the LNG-IUS compared to copper intrauterine devices (IUDs), patient satisfaction with the LNG-IUS and previous knowledge about it, and demographic characteristics of the population using IUDs. All forms were completed on an anonymous basis.


RESULTS
The questionnaire was returned, properly completed, by 298 physicians, yielding a response rate of 99.3%. Almost one-half of the physicians (n = 147, 49.3%) used the LNG-IUS only as a contraceptive device, 17.4% only as treatment for menorrhagia, and 33.2% for both indications. The vast majority of gynecologists (82.2%) reported a patient satisfaction rate of 70% or more. Among the gynecologists using the LNG-IUS as treatment for menorrhagia, the estimated overall patient satisfaction rate was more than 50%. Although most physicians expressed greater patient satisfaction with the LNG-IUS than with copper-releasing IUDs (p < 0.004), the majority of gynecologists still used the copper-releasing IUDs more frequently. Most considered the LNG-IUS as an appropriate method for endometrial protection in postmenopausal women using estrogen replacement therapy.


CONCLUSIONS
Physicians should be made aware of the beneficial health effects of the LNG-IUS, particularly in premenopausal women with menorrhagia and for endometrial protection during hormone replacement.
Ben-Haroush
A
A
Department of Obstetrics and Gynecology, Rabin Medical Center, Petach Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Oron
G
G
Yogev
Y
Y
Yeshaya
A
A
Kaplan
B
B
D000328:Adult; D001291:Attitude of Health Personnel; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D005260:Female; D006176:Gynecology; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000706:statistics & numerical data*; D007557:Israel; D016912:Levonorgestrel / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel