The levonorgestrel intra-uterine system: therapeutic application in family planning

To assess the non-contraceptive benefits of the levonorgestrel intra-uterine system 12 months following insertion in a family planning setting.

Postal questionnaire survey.

Family planning clinics at the Ulster and Bangor Hospitals.

Eighty-six consecutive subjects fitted with the levonorgestrel intra-uterine system.

Response rate 87.3%. Outcome measured in terms of compliance, satisfaction and menstrual symptomatology. Reasons for insertion were as follows: 21.7% contraception only; 65.2% menorrhagia, 24.6% dysmenorrhoea and 1.4% premenstrual syndrome. Duration of menses was 8.25 days pre-insertion and 2.41 days at 12 months. Of the subjects, 59.4% experienced at least one hormonal side effect; 10.1% of systems were removed within 12 months. At 12 months 86.9% of women were satisfied and 9.8% of women planned to discontinue.

The levonorgestrel intra-uterine system was acceptable to almost 80% of women after 12 months, with significant reduction in duration of menses. Family planning clinics are an ideal setting to implement the guidelines for the initial management of menorrhagia.