Clinical performance of the levonorgestrel intrauterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report.

OBJECTIVES This study was undertaken to determine the performance of the levonorgestrel intrauterine system (LNG IUS) in British women in routine clinical use. DESIGN Doctors working in general practice and at family planning clinics throughout the UK who collaborate in the UK Family Planning and Reproductive Health Research Network were responsible for the fitting of 678 LNG IUSs. RESULTS Gross cumulative event rates at 5 years per 100 women were pregnancy 1.0, expulsion 5.9, removal for bleeding problems 16.7, removal for pain 4.3, and removal for pelvic inflammatory disease (PID) 1.2. Removals were also required for side effects that may be due to absorbed levonorgestrel. Positive effects include effective contraception and considerably reduced quantity of bleeding for most participants. CONCLUSIONS A need was identified to counsel women about the early bleeding problems including the possibility of oligomenorrhoea or amenorrhoea. This is considered to be very important as it will help women to persevere so that they can enjoy the longer-term benefits.