title: Serum and peritoneal fluid levels of levonorgestrel in women with endometriosis who were treated with an intrauterine contraceptive device containing levonorgestrel.
abstract: OBJECTIVE
  To determine and compare levels of levonorgestrel (Lng) in serum and peritoneal fluid (PF) of patients on the Lng intrauterine system Mirena (Schering Health, Berlin, Germany) for endometriosis and to relate these to symptoms.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  Gynecology unit of a teaching hospital.
  
  
  METHODS
  Women with minimal to moderate endometriosis at diagnostic laparoscopy.
  
  
  METHODS
  Mirena was inserted at diagnostic laparoscopy and blood and PF collected for Lng levels. Levonorgestrel was again quantified in serum at 1, 3, and 6 months and PF at 6 months.
  
  
  METHODS
  Serum and PF Lng levels during 6 months, differences in levels before and 6 months after Mirena insertion, and the relationship between these levels and symptoms of endometriosis.
  
  
  RESULTS
  There was significant improvement in symptoms after 6 months on Mirena. The mean (SD) serum Lng levels were 459.2 (100.2), 368.2 (51.8), and 357.3 (53.0) pg/mL at 1, 3, and 6 months, respectively. The PF levels at 6 months were approximately two-thirds the serum levels in patients showing improvement in symptoms.
  
  
  CONCLUSIONS
  Mirena delivers significant amounts of Lng into the PF and serum. The relationship between Lng levels in these compartments is linear.
authors.affiliation: Reproductive Sciences Section, Department of Cancer Studies and Molecular Medicine, Leicester Royal Infirmary and University of Leicester, Leicester, United Kingdom.
authors.forename: Farhana B
authors.initials: FB
authors.lastname: Lockhat
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Emembolu
authors.forename: Justin C
authors.initials: JC
authors.lastname: Konje
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000378:metabolism; D003271:Contraceptive Agents, Female / Q000097:blood / Q000493:pharmacokinetics*; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D016912:Levonorgestrel / Q000097:blood / Q000493:pharmacokinetics*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel