title: Experience with the levonorgestrel-releasing intrauterine system among HIV-infected women.
abstract: BACKGROUND
  Safe and effective contraception is needed for women infected with human immunodeficiency virus (HIV). The levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective long-term contraceptive that reduces menstrual bleeding and may reduce the risk of pelvic inflammatory disease. Yet, little is known about LNG-IUS use in HIV-infected women.
  
  
  METHODS
  Six HIV-infected women had the LNG-IUS inserted between March 1998 and October 2002, and were systemically followed for a mean of 45 months. Indications for LNG-IUS use were contraception in four women and menorrhagia in two women.
  
  
  RESULTS
  The LNG-IUS was well tolerated, and menstrual bleeding was reduced in all women. Blood hemoglobin levels increased in each subject, with mean levels being 123 g/L (SD=11.7) before LNG-IUS insertion and 135 g/L (SD=8.7) at 1 year (p=.01). Levels of circulating CD4 lymphocytes and Pap smear findings remained unchanged.
  
  
  CONCLUSIONS
  Our limited experience with LNG-IUS use in HIV-infected women is encouraging. The LNG-IUS may be used as an alternative to uterine surgery in HIV-infected women with menorrhagia.
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki, SF-00029 Helsinki, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Lehtovirta
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.forename: Oskari
authors.initials: O
authors.lastname: Heikinheimo
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000494:pharmacology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000635:transmission*; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000494:pharmacology*; D008137:Longitudinal Studies; D008595:Menorrhagia / Q000188:drug therapy* / Q000821:virology; D008598:Menstruation / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000517:prevention & control; D012449:Safety; D016896:Treatment Outcome; D017201:Virus Shedding
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel