Recent developments in the clinical use of the levonorgestrel-releasing intrauterine system.

This overview focuses on recent developments in the clinical use of the levonorgestrel- releasing intrauterine system (LNG-IUS) on established indications. Recent studies confirm that the LNG-IUS is safe and equally effective for all age groups of women. All available studies showed that intrauterine contraception is more effective when compared to non-intrauterine contraceptive methods to prevent repeat abortions. Furthermore, insertion in young nulliparous women is acceptable in the majority of women and associated with high continuation rates. The effectivity of LNG-IUS appears to be similar in women with chronic medical conditions, including HIV infection or coagulation disorders, and healthy women. More and most importantly, it has no adverse effect on the underlying condition. We also discuss effects of LNG-IUS on bone mineral density, vaginal flora, cardiovascular risk factors and breast cancer. In treatment of heavy menstrual bleeding, the LNG-IUS appears to be one of the most effective and cost-effective methods.