Department of Obstetrics and Gynecology, Sapienza University of Rome, Rome, Italy.
Contraception. 2011 Oct;84(4):402-8. doi: 10.1016/j.contraception.2011.01.020. Epub 2011 Mar 9.
The levonorgestrel-releasing intrauterine system (LNG-IUS) was first marketed in 1990 in Finland. Since then, it has been approved in approximately 120 countries throughout the world, with almost 50 million women-years of cumulative experience to date. Its high contraceptive effectiveness and favorable bleeding profile, leading to significant reduction of menstrual bleeding both in women with idiopathic menorrhagia and in those with normal menstrual bleedings, have been the key to the success of the system. At the same time, women need to be provided adequate preinsertion counseling about changes in menstrual bleeding to be expected. In the Italian context, it is important to highlight during counseling that amenorrhea is not harmful but can lead to health benefits such as an increase in iron blood stores and blood hemoglobin concentration.
To evaluate contraceptive efficacy, compliance and the effect of changes in menstrual cyclicity on quality of life and sexuality of the LNG-IUS (Mirena®), 156 women attending the Family Planning Clinic to request contraception were enrolled in the study and inserted with the device.
Menstrual blood flow decreased in all users, in terms of both quantity and duration; although spotting was present in 93.7% of the women, it disappeared within 6 months in the majority of cases. Amenorrhea occurred in 29.5% of all women, with onset within the first six cycles postinsertion. Data from the EuroQuality of Life-5D and Female Sexual Function Index questionnaires showed improvement in the quality of life, with a decrease in intercourse-related pain and an improvement in sexual desire.
Although in Italy intrauterine contraception is poorly accepted, once started on LNG-IUS, women found that the device represents a safe and effective contraceptive modality, with valuable noncontraceptive benefits, especially in the presence of heavy or prolonged bleeding.
左炔诺孕酮宫内节育系统（LNG-IUS）于 1990 年在芬兰首次上市。自那时以来，它已在全球约 120 个国家获得批准，迄今为止已有近 5000 万妇女使用了该系统。其高效的避孕效果和良好的出血模式，导致异常子宫出血的女性和月经出血正常的女性的月经出血量都显著减少，这是该系统成功的关键。同时，需要向女性提供充分的插入前咨询，告知其预期的月经出血变化。在意大利，重要的是要在咨询中强调，闭经并非有害，反而可能带来益处，如增加铁储备和血红蛋白浓度。
为了评估 LNG-IUS（Mirena®）的避孕效果、顺应性以及月经周期变化对生活质量和性行为的影响，对 156 名到计划生育诊所要求避孕的女性进行了研究，并为她们插入了该设备。
所有使用者的月经出血量均减少，无论是在数量还是持续时间上；尽管 93.7%的女性存在点滴出血，但大多数女性在 6 个月内消失。所有女性中有 29.5%出现闭经，闭经发生在插入后的前 6 个周期内。来自 EuroQuality of Life-5D 和女性性功能指数问卷的数据显示，生活质量得到改善，性交相关疼痛减轻，性欲提高。
尽管宫内节育在意大利的接受度较低，但一旦开始使用 LNG-IUS，女性就会发现该设备是一种安全有效的避孕方式，具有有价值的非避孕益处，尤其是在存在大量或长时间出血的情况下。
