Elsevier

Contraception

Volume 67, Issue 2, February 2003, Pages 87-91
Contraception

Original research article
Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena®): a 3-year follow-up study

https://doi.org/10.1016/S0010-7824(02)00482-1Get rights and content

Abstract

This study investigated the long-term acceptability of a levonorgestrel-releasing intrauterine system (LNG-IUS) in 165 women after 6 and 36 months of use. Changes in menstrual bleeding pattern were experienced by 161 (98%) women, with a cessation or transient absence of menstruation occurring in 75 (47%) and 14 (9%) women, respectively. Amenorrhea was considered by most women (81%) as a positive change. The proportion of women with menstrual pain was reduced from 60% before use to 29% after 36 months of use with the LNG-IUS. Fear of an unwanted pregnancy became less widespread with duration of use and the device had no disturbing effects on the women or their partners during sexual intercourse. The number of women expressing that they were very satisfied with the LNG-IUS was 69% and 77% after six months and 36 months of use, respectively. LNG-IUS is a well-accepted contraceptive method, without negative influences on the sexual relationship between users and their partners, and is suitable for women requiring long-term reversible contraceptive protection.

Introduction

There is extensive documentation of the contraceptive efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) [1], [2], but as yet little is known about the subjective opinion of users during its long-term use. Consequently, we designed the present study to investigate the acceptance of, and satisfaction with, the LNG-IUS as a long-term contraceptive method during 3 years of use.

Section snippets

Material and methods

The LNG-IUS (Mirena®; Schering AG, Berlin) has been registered for marketing in Austria since 1997. Between January 1997 to April 1997, a total of 554 women who required long-term contraception were enrolled in an observational study of LNG-IUS to familiarize gynecologists with its use. The participants were under the supervision of 112 office-based gynecologists. Before enrolment, women were given verbal and written information about the LNG-IUS, including its possible effects on menstrual

Demographic characteristics and reasons for discontinuation

A total of 47 gynecologists (47/52; 90%) continued in the study after 6 months and informed their patients (187 women) of the follow-up questionnaire at 36 months. Of these women, 165 (165/187; 88%) returned the questionnaire at 36 months, so data were available from these subjects at both the 6-month and 36-month timepoints. Only data from these 165 participants were used for further statistical analysis. At the time of LNG-IUS insertion, these patients had a mean age of 37.9 years (SD ± 6.0

Discussion

Knowledge of the personal experience, acceptance and satisfaction of users is important if the selection of a long-term contraceptive is to meet individual needs. We investigated the psycho-social elements of long-term contraception with a LNG-IUS by gathering data over a 3-year period. Demographic characteristics revealed respondents had a mean age of 38 years (range: 25 to 47 years) and most were employed. The majority of women already had children, and no desire for further offspring, and so

Acknowledgements

The authors are grateful to Nina Andrzejak-Nolten and Ulrich Ganzinger for their useful discussions, and to Schering Wien GesmbH for financial support.

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