Continuation Rates of the 52-mg Levonorgestrel-releasing Intrauterine System according to the Primary Reason for its Use

• Published in: Revista Brasileira de ginecologia e obstetrícia Vol. 43; no. 4; pp. 291 - 296
• Main Authors: Miranda, Laura, Sousa, Maria Helena de, Faundes, Anibal, Juliato, Cássia
• Format: Journal Article
• Language: English
• Published: Brazil Thieme Revinter Publicações Ltda 01-04-2021; Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
• Subjects: Adult; amenorrhea; bleeding and spotting; Brazil; continuation rate; Contraceptive Agents, Hormonal - administration & dosage; Contraceptive Agents, Hormonal - adverse effects; Counseling; counselling; Educational Status; Female; Follow-Up Studies; Humans; indication for use; Intrauterine Devices, Medicated - adverse effects; Levonorgestrel - administration & dosage; Levonorgestrel - adverse effects; levonorgestrel IUS; Marital Status; Menstruation Disturbances; OBSTETRICS & GYNECOLOGY; Original; Parity; Patient Education as Topic; Regression Analysis; Retrospective Studies; Young Adult; Brazil; counselling; amenorreia; bleeding and spotting; sistema liberador de levonorgestrel (SIUS); indicação para uso; aconselhamento; indication for use; taxa de continuação; sangramento e microrragia intermenstrual; continuation rate; amenorrhea; levonorgestrel IUS
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.1055/s-0041-1726056

To evaluate whether continuation rates with the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) up to 5 years after placement differed between women using the method exclusively for contraception and those using the device for medical reasons alone.
 A retrospective cohort study was conducted in a family planning clinic with 5,034 LNG-IUS users: 4,287 using the method exclusively for contraception and 747 for medical reasons alone. The continuation rate at 1 to 5 years of use was calculated by life table analysis.
 Initially, the continuation rate was significantly higher in the contraception group: 85.8 versus 83.4 and 77.4 versus 76.0 per 100 women-years in the 1
and 2
years of use, respectively. There were more discontinuations due to bleeding/spotting in the medical reasons group in the first two years. The discontinuation rate according to reason for use was not significantly different from the third to the fifth year of use. No women discontinued due to amenorrhea in either group.
 The continuation rate was significantly higher in the contraception group in the first two years of use. Amenorrhea was not a reason for discontinuation in either group, suggesting that counselling in this respect was adequate. Nevertheless, counselling could perhaps have been better with regards to the expected long period of bleeding and spotting in the first two years after placement.