title: Acceptability of the levonorgestrel intrauterine system in the long-term treatment of heavy menstrual bleeding: how many women choose to use a second device?
abstract: OBJECTIVE
  To assess the acceptability of the levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena®) in the long-term treatment of heavy menstrual bleeding.
  
  
  METHODS
  Retrospective study of all consecutive women who had a LNG-IUS inserted for control of idiopathic heavy menstrual bleeding between January 2000 and December 2003. Duration of use, reasons for early removal, number of devices removed after 5 years of use, and number of women who decided to use a second LNG-IUS were assessed.
  
  
  RESULTS
  Of a total of 216 devices inserted, 129 (59.7%) were removed after 5 years of use, 68 (31.5%) were removed anytime before the completion of 5 years, and the remaining 19 (8.8%) patients were lost to follow-up. In 32 of the 68 cases (47.1%) with early removal of the LNG-IUS, the main reason for discontinuation was the appearance of the menopause. After the 5-year effective lifetime of the LNG-IUS, 51 of the 129 women (39.5%) chose to have a second device inserted. Of the 78 women who completed the 5-year treatment period and did not decide to use the LNG-IUS again, 71 (91%) had reached the menopause.
  
  
  CONCLUSIONS
  The LNG-IUS was well accepted by women with idiopathic heavy menstrual bleeding as shown by 39.5% of users (or 87.9% if menopausal women are excluded) deciding to use a second device when the first LNG-IUS expired after 5 years of use.
authors: Service of Gynecology, Hospital Santiago Apóstol, Servicio Vasco de Salud-Osakidetza, Vitoria-Gasteiz, Álava, Spain. ilete@hsan.osakidetza.net
authors: Iñaki
authors: I
authors: Lete
authors: María
authors: M
authors: del Carme Cuesta
authors: Juan M
authors: JM
authors: Marín
authors: Miguel
authors: M
authors: Martínez
authors: Asunción
authors: A
authors: Bermejo
authors: Roberto
authors: R
authors: Arina
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage*; D008593:Menopause; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies
chemical_list: D016912:Levonorgestrel