Department of Maternal & Child Health, Gynecology and Urology, Sapienza, University of Rome, Rome, Italy.
Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.
Eur J Contracept Reprod Health Care. 2022 Feb;27(1):16-22. doi: 10.1080/13625187.2021.1975269. Epub 2021 Sep 16.
Current research fails to adequately inform about the differential use of available levonorgestrel-releasing intrauterine systems (LNG-IUSs) in real life. Aim of our study was to compare the characteristics, satisfaction, continuation rates, and adverse effects between users of the high-dose LNG-IUS (52 mg) and of the low dose LNG-IUS (13.5 mg and 19.5 mg).
A prospective cohort study was performed in two Services for Family Planning in normal menstruating women with the inclusion of all new prescriptions of LNG-IUS for contraception. Women were followed for a mean of 9.1 ± 2.6 months after placement.
109 women (mean age of 39.8 ± 8.7 years old) were included, 69.7% using a high dose LNG-IUS and 30.3% using a low dose LNG-IUS. Women with a low dose LNG-IUS were significantly younger, thinner, more nulliparous, with fewer vaginal deliveries and C-sections, with a lower menstrual flow length and with more previous use of short-acting reversible contraceptives ( < 0.05). LNG-IUS continuation was similar and very high at the last follow-up: 100 vs. 94.7% in the low and high dose LNG-IUS groups, respectively ( = 0.18). Satisfaction with treatment at the end of the study was similar between different LNG-IUS doses ( = 0.85), with 78.9% being satisfied/very satisfied. Bleeding patterns were significantly different between the two LNG-IUS doses ( < 0.0001). Diagnosis of dysfunctional cysts was more frequent in women with high dose compared to low dose LNG-IUS (22.2 vs. 12.1%), albeit not significantly.
We have shown a clear differential use of available LNG-IUS in clinical practice, both as baseline characteristics and as different outcomes, primarily for bleeding patterns. However, all these systems were associated with a very high rate of satisfaction and continuation.
目前的研究未能充分了解现有左炔诺孕酮释放宫内节育系统（LNG-IUS）在实际生活中的差异使用。我们研究的目的是比较高剂量 LNG-IUS（52mg）和低剂量 LNG-IUS（13.5mg 和 19.5mg）使用者的特征、满意度、续用率和不良反应。
在两家计划生育服务机构对正常月经的妇女进行了一项前瞻性队列研究，包括所有新的 LNG-IUS 避孕处方。在放置后平均随访 9.1±2.6 个月。
共纳入 109 例妇女（平均年龄 39.8±8.7 岁），其中 69.7%使用高剂量 LNG-IUS，30.3%使用低剂量 LNG-IUS。低剂量 LNG-IUS 使用者明显更年轻、更瘦、更多为未婚、更少阴道分娩和剖宫产、月经流血时间更短、既往使用短效可逆避孕药更多（ < 0.05）。LNG-IUS 续用率在最后一次随访时相似且非常高：低剂量和高剂量 LNG-IUS 组分别为 100%和 94.7%（ = 0.18）。研究结束时对治疗的满意度在不同 LNG-IUS 剂量之间相似（ = 0.85），78.9%为满意/非常满意。两种 LNG-IUS 剂量的出血模式有显著差异（ < 0.0001）。高剂量 LNG-IUS 组诊断为功能性囊肿的比例高于低剂量 LNG-IUS 组（22.2%比 12.1%），尽管差异无统计学意义。
我们已经表明，在临床实践中，可用的 LNG-IUS 的使用存在明显差异，无论是基线特征还是不同的结果，主要是与出血模式有关。然而，所有这些系统都与非常高的满意度和续用率相关。
