title: Levonorgestrel-Releasing Intrauterine System for Women With Polycystic Ovary Syndrome: Metabolic and Clinical Effects.
abstract: Polycystic ovary syndrome (PCOS) is related to clinical and metabolic comorbidities that may limit the prescription of combined hormonal contraceptives, with consequent need to use progestogen-only contraceptives (POCs). Thus, the objective of the present study was to evaluate the clinical and metabolic effects of a POC, the levonorgestrel-releasing intrauterine system (LNG-IUS), in women with PCOS followed up over a period of 6 months compared to baseline and to women without PCOS. Thus, an observational, prospective, controlled study was conducted on 30 women with a diagnosis of PCOS who presented adverse effect secondary to the use of combined oral contraceptives (nausea, headache, mastalgia or vomiting; PCOS group) paired with 30 ovulatory women without PCOS (control group), both groups being free of comorbidities and having chosen the LNG-IUS as contraceptive. Clinical, laboratory, and ultrasonographic variables were evaluated immediately before LNG-IUS insertion and 6 months after the use of this method. Before LNG-IUS insertion, the PCOS group had higher total testosterone levels (P = .04), lower HDL levels (P = .04), and greater ovarian volume (P < .01) than the control group. Six months after LNG-IUS insertion, there was a 2.3% increase in abdominal circumference (P = .04) and a 3.4% increase in fasting glycemia (P = .02). On the other hand, mean ovarian volume was 10% smaller compared to the volume found before LNG-IUS insertion (P = .04), LDL levels were reduced by 5.2% (P = .03), and total cholesterol levels were reduced by 6.7% (P < .01) compared to baseline evaluation in the PCOS group. The remaining variables did not differ significantly during the 6 months of observation. The control group did not show significant changes compared to the period before LNG-IUS insertion. When the groups were compared after the 6-month follow-up, only glycemia showed a statistically significant variation between the groups, with glycemia levels increasing by 3.4% in the PCOS group and decreasing by 2.6% in the control group (P = .008). In conclusion, the use of the LNG-IUS for 6 months was not associated with relevant changes in clinical or metabolic variables of women with no comorbidities regardless of the presence of PCOS.
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Adriana Valerio
authors.initials: AV
authors.lastname: da Silva
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Anderson Sanches
authors.initials: AS
authors.lastname: de Melo
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Rebecca Pontelo
authors.initials: RP
authors.lastname: Barboza
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Wellington
authors.initials: W
authors.lastname: de Paula Martins
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Rui Alberto
authors.initials: RA
authors.lastname: Ferriani
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, Ribeirão Preto, Brazil carol.sales@uol.com.br carol.sales@usp.br.
authors.forename: Carolina Sales
authors.initials: CS
authors.lastname: Vieira
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel / Q000009:adverse effects*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000378:metabolism*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: contraception; levonorgestrel-releasing intrauterine system; polycystic ovary syndrome; progestogens