Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio.
Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio.
J Adolesc Health. 2019 Jul;65(1):32-38. doi: 10.1016/j.jadohealth.2018.11.010. Epub 2019 Jan 26.
The aim of the study was to evaluate the experience of menstruating adolescents identifying as male or gender nonconforming with the levonorgestrel-releasing intrauterine system (LNG-IUS) as a method of menstrual suppression and compare to that of cisgender youth (CGY) using the LNG-IUS for noncontraceptive indications.
A retrospective chart review of gender minority youth (GMY), aged 12-22 years, who self-selected the 52 mg LNG-IUS for menstrual suppression between June 2014 and January 2018. GMY were then matched for age and time of insertion with CGY. Subjects were contacted by telephone to further explore LNG-IUS experience such as if the device was still in place, method satisfaction, current bleeding patterns, and for GMY improvement in menstrual distress.
Thirty GMY had the LNG-IUS inserted during the study period, and 20 GMY were matched with CGY for age and time of insertion. GMY were significantly more likely to receive sedation for LNG-IUS insertion (50% vs. 15%, p = .04). Otherwise, the LNG-IUS experience was similar between groups, including mean number of telephone/office visit encounters for an LNG-IUS concern, expulsion and reinsertion rates, and need for additional medications to control bleeding. On average, the mean months of use was 14.5 ± 8.6 months in GMY and 14.6±11.5 in CGY (p = .97). LNG-IUS removal was documented in three (15%) of GMY and five (25%) of CGY. Improvement in menstrual distress was reported by 80% of GMY after the insertion of the LNG-IUS.
Overall experience with the LNG-IUS was similar for GMY and CGY, and menstrual distress and bleeding pattern improved in the majority of GMY who self-selected this method for menstrual suppression.
本研究旨在评估将左炔诺孕酮宫内释放系统（LNG-IUS）作为抑制月经方法的男童或性别认同障碍青少年（GMY）的使用经验，并与使用 LNG-IUS 进行非避孕适应证的顺性别青少年（CGY）进行比较。
对 2014 年 6 月至 2018 年 1 月期间自行选择 52mg LNG-IUS 进行月经抑制的 12-22 岁性别少数青少年（GMY）进行回顾性图表审查。然后，根据年龄和插入时间将 GMY 与 CGY 进行匹配。通过电话联系受试者，进一步探讨 LNG-IUS 的使用经验，例如装置是否仍在原位、方法满意度、当前出血模式，以及 GMY 的月经困扰是否有所改善。
研究期间有 30 名 GMY 插入了 LNG-IUS，其中 20 名 GMY 与 CGY 按年龄和插入时间匹配。GMY 接受 LNG-IUS 插入镇静的可能性明显更高（50% vs. 15%，p =.04）。除此之外，两组的 LNG-IUS 使用经验相似，包括因 LNG-IUS 问题就诊的电话/办公室访问次数、脱落和重新插入率以及控制出血所需的额外药物。平均而言，GMY 的使用月数为 14.5±8.6 个月，CGY 为 14.6±11.5 个月（p =.97）。有 3 名（15%）GMY 和 5 名（25%）CGY 的 LNG-IUS 被取出。插入 LNG-IUS 后，80%的 GMY 报告月经困扰得到改善。
GMY 和 CGY 对 LNG-IUS 的总体使用经验相似，大多数自行选择该方法抑制月经的 GMY 月经困扰和出血模式得到改善。
