Indications and reasons for discontinuing the levonorgestrel-releasing intrauterine system (LNG-IUS)

Abstract Objectives: to identify the main indications and reasons for discontinuing the use of the Levonorgestrel-Releasing Intrauterine System (LNG-IUS). Methods: a cross-sectional study was carried out from medical records of 327 women who used the LNG-IUS 52mg between January 2011 and December 2016 at a public hospital in the Northeast of Brazil. Results: the main indications for the use of the LNG-IUS were: contraception (32.7%), myoma/metrorrhagia (28.7%) and endometriosis/pelvic pain (22.3%). Of the 327 women, 68 (20.8%) had discontinued using the device. The most frequent reasons for discontinuation were: expulsion (9.2%), LNG-IUS expiration (3.7%), bleeding (2.4%) and pain (1.5%). Most patients had no difficulty in the insertion and did not require anesthesia/sedation. Among the 30 women who expelled the device, 17 (56.7%) had used it for metrorrhagia and myoma, 8 (26.7%) for contraception, and 5 (16.6%) for endometriosis/pelvic pain. Conclusions: the LNG-IUS is a well-accepted contraceptive method, with therapeutic applications for some gynecological conditions and a low expulsion rate.

摘要
研究目的：明确左炔诺孕酮宫内缓释系统（Levonorgestrel-Releasing Intrauterine System, LNG-IUS）的主要应用指征及停用原因。
研究方法：本研究为横断面研究，调取巴西东北部某公立医院2011年1月至2016年12月期间，327名使用52mg左炔诺孕酮宫内缓释系统的女性的病历资料开展分析。
研究结果：左炔诺孕酮宫内缓释系统的主要应用指征包括：避孕（32.7%）、子宫肌瘤/子宫异常出血（28.7%）以及子宫内膜异位症/盆腔疼痛（22.3%）。327名研究对象中，共有68人（20.8%）停用了该装置。最常见的停用原因依次为：装置脱落（9.2%）、左炔诺孕酮宫内缓释系统有效期届满（3.7%）、出血（2.4%）以及疼痛（1.5%）。多数患者在装置放置过程中无明显不适，且无需接受麻醉或镇静处理。在30名发生装置脱落的研究对象中，17人（56.7%）因子宫异常出血和子宫肌瘤使用该装置，8人（26.7%）用于避孕，5人（16.6%）用于子宫内膜异位症/盆腔疼痛。
研究结论：左炔诺孕酮宫内缓释系统是一种认可度较高的避孕方式，可用于部分妇科疾病的治疗，且装置脱落率较低。