Contraceptive and therapeutic effects of the levonorgestrel intrauterine system: an overview.
The levonorgestrel intrauterine system (LNG IUS), a steroid-releasing intrauterine system, is a T-shaped device that releases levonorgestrel directly into the uterine cavity at an initial rate of 20 mug per day. The contraceptive and therapeutic benefits of the LNG IUS stem primarily from its local effects. The local hormone delivery causes high levonorgestrel levels in the endometrial tissue but low levels in the systemic circulation. This leads to strong endometrial suppression and, in many cases, a dramatic reduction in menstrual blood loss. The high contraceptive efficacy is well documented through extensive international clinical research. This review article provides an overview of the LNG IUS and addresses the following topics: mechanisms of action, contraceptive efficacy, changes in bleeding patterns, principal safety issues, potential noncontraceptive benefits, and implications for women's reproductive health.


BACKGROUND
Obstetricians & Gynecologists, Family Physicians.


OBJECTIVE
After completion of this article, the reader should be able to explain that the levonorgestrel intrauterine system (LNG IUS) has contraceptive and therapeutic benefits, identify the main site of action as the endometrium, and to recall that the safety of the system has been validated over time.
Jensen
Jeffrey T
JT
Department of Obstetrics and Gynecology, UHN-70, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA. jensenje@ohsu.edu
D003267:Contraception; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D014592:Uterine Hemorrhage / Q000188:drug therapy
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel