title: A nationwide cohort study of the use of the levonorgestrel intrauterine device in New Zealand adolescents.
abstract: BACKGROUND
  While the use of the levonorgestrel intrauterine device (LNG-IUD) is well established in the adult population, there have been no research studies specifically on the use of the LNG-IUD in adolescents.
  
  
  METHODS
  A nationwide cohort study of 179 adolescents in New Zealand using the LNG-IUD, by means of a follow-up questionnaire to their practitioner, was conducted to determine the indications for insertion of the LNG-IUD and to establish patterns of use, including duration of use and reasons for removal.
  
  
  RESULTS
  The study, with a 94% response rate, demonstrated that the most common indication for use was menorrhagia (17%); 29% of adolescents had an "off-label" primary indication. There was a 1-year continuation rate of 85%. The cumulative incidence of expulsion was 8%.
  
  
  CONCLUSIONS
  The results of this study should be reassuring for practitioners and adolescents considering use of the LNG-IUD. However, further research is required into the safety and efficacy of the LNG-IUD in adolescents especially in the management of off-label indications.
authors.affiliation: Dunedin School of Medicine, Department of Women's and Children's Health, University of Otago Dunedin, New Zealand. helen.paterson@otago.ac.nz
authors.forename: Helen
authors.initials: H
authors.lastname: Paterson
authors.forename: Janelle
authors.initials: J
authors.lastname: Ashton
authors.forename: Mira
authors.initials: M
authors.lastname: Harrison-Woolrych
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D009520:New Zealand; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D016912:Levonorgestrel