THE NON-CONTRACEPTIVE EFFECTS OF THE LEVONORGESTREL-RELEASING INTRAUTERINE-DEVICE

Clinical trials have consistently shown that the IUD that releases 20 mu g levonorgestrel daily (LNG-IUD-20) has a contraceptive efficacy co mparable to, if not surpassing, the Copper T380 and the Multiload Copp er-375 IUDs. The focus of this review is the device's non-contraceptiv e effects - the beneficial ones, such as reduction of menorrhagia, a t herapeutic effect on dysmenorrhea, and prevention of ectopic pregnancy , as well as the deleterious ones, such as amenorrhea, spotting and ir regular bleeding, hormonal side-effects, and functional ovarian cysts. Also discussed are the possibility of a preventive effect on pelvic i nflammatory disease, the effects of the IUD on postpartum/lactating wo men, fertility return after removal and other safety issues. In genera l, 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 tran sient in nature, and can usually be managed satisfactorily by counseli ng. A better understanding of these effects, both beneficial and delet erious, of this hormone-releasing IUD should lead to more effective pa tient counseling, which, in turn, should improve user quality of life, minimize unnecessary removals, and maximize continuation of use.