breakthrough bleeding (btb) is the cause of 50% of discontinuations of use by long-acting progestogen-only contraceptive users. btb appears to be associated with capillaries of abnormal morphology and fragility. disturbances in vessels integrity, intercellular junctions or alteration of the basement membrane (bm) composition has been proposed to contribute toward the fragility of these capillar...

The incidence of ectopic pregnancy has been increasing over the last few years, reaching a value of 1 case in 80 pregnancies, and it continues to be the main cause of maternal death during the first trimester in the United States. The main causes of tubal ectopic pregnancy, which generally results from damage to or dysfunction of the fallopian tubes, are salpingitis, previous tubal surgeries, a...

OBJECTIVE To estimate the relative cost effectiveness for women aged > or =30 years, starting long-term hormonal contraception with either levonorgestrel intrauterine system (Mirena), etonogestrel subdermal implant (Implanon) or medroxyprogesterone acetate injection (Depo-Provera). DESIGN AND SETTING This was a modelling study, performed from the perspective of the UK NHS, of contraceptive se...

OBJECTIVE To evaluate a new levonorgestrel-releasing intrauterine system (LNG-IUS) called Levosert(®) for the treatment of heavy menstrual bleeding (HMB) in comparison to the reference product Mirena(®). METHODS A multicentre, randomised, controlled trial, in non-menopausal women diagnosed with functional HMB (defined as menstrual blood loss [MBL] ≥ 80 mL) randomised to either Levosert(®) or ...

A 45-year-old nulliparous woman attended for removal and replacement of a levonorgestrel-releasing intrauterine system (IUS) for continued management of dysmenorrhoea. I had placed the IUS some 6 years previously under a cervical block, needing to dilate the tight cervical canal for insertion. The patient’s periods had been well controlled. The IUS was easily removed but, as pictured, the arms ...

OBJECTIVE To assess 3-year data on the efficacy and safety of a new 52-mg levonorgestrel intrauterine contraceptive (LNG20) designed for up to 7 years use. STUDY DESIGN Nulliparous and parous women aged 16-45 years at enrollment with regular menstrual cycles and requesting contraception were enrolled in an open-label, partially randomized trial to evaluate LNG20. The primary outcome was pregn...

BACKGROUND Although surveys conducted in Western countries have shown that the levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena(®)) is well accepted by European women, its acceptance by Chinese women is not yet clearly known. The purpose of this study was to analyze the experiences and levels of satisfaction with Mirena among Chinese women living in 12 different cities. METHODS I...

BACKGROUND Use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in humans may alter vaginal microbial populations and susceptibility to pathogens. This study evaluated the time-dependent effects of an LNG-IUS on the vaginal microbiome of the baboon, a useful animal model for reproductive studies. METHODS Levonorgestrel-releasing intrauterine systems were inserted into three reprodu...