title: Levonorgestrel-releasing intrauterine system: why do some women dislike it?
abstract: BACKGROUND
  There is growing evidence of women's dissatisfaction with the levonorgestrel-releasing intrauterine system (LNG-IUS) because of a high incidence of adverse effects.
  
  
  OBJECTIVE
  To quantify the continuation rate and users' satisfaction, and identify symptoms associated with early removal before the 5-years effective life-time.
  
  
  METHODS
  A questionnaire was sent to 212 women, who had LNG-IUS inserted from 1 January 1998 to 31 December 2003 at The Ipswich Hospital, UK.
  
  
  RESULTS
  The response rate was 76% (n = 161), 16 of the respondents were excluded and the data of 145 are presented. The continuation rate was 85%, 70%, 59%, 56%, 50% and 50% at 6 months, 1, 2, 3, 4 and 5 years, respectively. The total number of women who had the LNG-IUS removed before 5 years was 72 (50%), and the median duration of use was 270 days (range 4-1460). The reasons for early removal were unscheduled bleeding, progestogenic adverse effects, abdominal pain and others in 40 (28%), 32 (22%), 19 (13%) and 19 (13%) women, respectively. Only 73 (50%) women were satisfied with LNG-IUS.
  
  
  CONCLUSIONS
  Our findings are similar to recent reports, and this information should be readily available to women to enable them to make an informed choice.
authors.affiliation: Department of Gynaecology, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK.
authors.forename: Suzanna
authors.initials: S
authors.lastname: Daud
authors.forename: Ayman A A
authors.initials: AA
authors.lastname: Ewies
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects / Q000592:standards*; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel