Chi I C, Farr G
Family Health International, Research Triangle Park, Durham 27709, USA.
Adv Contracept. 1994 Dec;10(4):271-85. doi: 10.1007/BF01984125.
Clinical trials have consistently shown that the IUD that releases 20 micrograms levonorgestrel daily (LNG-IUD-20) has a contraceptive efficacy comparable to, if not surpassing, the Copper T380 and the Multiload Copper-375 IUDs. The focus of this review is the device's non-contraceptive effects--the beneficial ones, such as reduction of menorrhagia, a therapeutic effect on dysmenorrhea, and prevention of ectopic pregnancy, as well as the deleterious ones, such as amenorrhea, spotting and irregular bleeding, hormonal side-effects, and functional ovarian cysts. Also discussed are the possibility of a preventive effect on pelvic inflammatory disease, the effects of the IUD on postpartum/lactating women, fertility return after removal and other safety issues. In general, the LNG-IUD-20's non-contraceptive benefits are substantive, carry important medical and public health implications, and far outweigh the device's deleterious effects, which are either medically mild or transient in nature, and can usually be managed satisfactorily by counseling. A better understanding of these effects, both beneficial and deleterious, of this hormone-releasing IUD should lead to more effective patient counseling, which, in turn, should improve user quality of life, minimize unnecessary removals, and maximize continuation of use.
临床试验一直表明，每日释放20微克左炔诺孕酮的宫内节育器（LNG - IUD - 20）的避孕效果即便不超过铜T380和多负载铜375宫内节育器，也与之相当。本综述的重点是该装置的非避孕作用——有益作用，如减少月经过多、对痛经有治疗作用以及预防异位妊娠；还有有害作用，如闭经、点滴出血和不规则出血、激素副作用以及功能性卵巢囊肿。还讨论了对盆腔炎的预防作用可能性、宫内节育器对产后/哺乳期妇女的影响、取出后生育能力恢复情况以及其他安全问题。总体而言，LNG - IUD - 20的非避孕益处显著，具有重要的医学和公共卫生意义，且远远超过该装置的有害作用，这些有害作用在医学上要么轻微，要么是短暂的，通常通过咨询就能得到令人满意的处理。更好地了解这种释放激素的宫内节育器的这些有益和有害作用，应能带来更有效的患者咨询，进而改善使用者的生活质量，尽量减少不必要的取出，并最大限度地提高继续使用率。
