Intrauterine polyps - a cause of unscheduled bleeding in women using the levonorgestrel intrauterine system

The levonorgestrel intrauterine releasing system is a contraceptive that ha s been shown to reduce menstrual blood loss dramatically. Breakthrough blee ding, however, is a relatively common occurrence as with all methods of pro gestogen-only contraception and this limits its acceptability for women. Am enorrhoea can be achieved in the majority of women within 12 months of inse rtion. Any new pattern of bleeding after amenorrhoea or a persistence of he avy bleeding may be due to co-existing intrauterine pathology such as endom etrial polyps. The use of out-patient techniques such as hysteroscopy and s aline infusion sonography are indicated in these instances to exclude other intrauterine pathology.