Usage of the levonorgestrel releasing intrauterine system in perimenopause


Authors: T. Fait 1,2
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha 1;  Katedra zdravotnických studií, Vysoká škola polytechnická, Jihlava 2
Published in: Ceska Gynekol 2024; 89(2): 156-159
Category:
doi: https://doi.org/10.48095/cccg2024156

Overview

Levonorgestrel releasing intrauterine system have excellent contraceptive efficacy with simultaneous lowering of menstruation’s blood loss. It could be used for therapy of endometrial hyperplasia in perimenopause. In position of gestagen part of the hormone replacement therapy it has high control of endometrial proliferation. It is conjoined with the zero increasing of risk of thromboembolic disease in combination with transdermal oestrogen’s application.

Keywords:

menopause – thromboembolic disease – hormone replacement therapy – levonorgestrel releasing intrauterine system


Sources

1. Luukkainen T. Issues to debate on the Women‘s Health Initiative: failure of estrogen plus progestin therapy for prevention of breast cancer risk. Hum Reprod 2003; 18 (8): 1559–1561. doi: 10.1093/humrep/deg305.

2. Biglia N, Cagnacci A, Gambacciani M et al. Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases? Climacteric 2017; 20 (4): 306–312. doi: 10.1080/13697137.2017.1315089.

3. Thurston R, Chang Y, Barinas-Mitchell E et al. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause 2017; 24 (8): 886–893. doi: 10.1097/GME. 0000000000000857.

4. Herber-Gast G, Brown WJ, Mishra GD. Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study. BJOG 2015; 122: 1560–1567. doi: 10.1111/1471-0528.13163.

5. Thurston RC, Aizenstein HJ, Derby CA et al. Menopausal hot flashes and white matter hyperintensities. Menopause 2016; 23 (1): 27–32. doi: 10.1097/GME.0000000000000481.

6. Kim J, Chang JH, Jeong MJ et al. A systematic review and meta-analysis of effects of menopause hormone therapy on cardiovascular diseases. Sci Rep 2020; 10 (1): 20631. doi: 10.1038/ s41598-020-77534-9.

7. Koire A, Joffe H, Buckley R. Menopausal hormone therapy and the mind: the role of hormone replacement in the prevention and treatment of cognitive decline, dementia, and cognitive dysfunction of depression. Harv Rev Psychiatry 2022; 30 (4): 215–222. doi: 10.1097/HRP.0000000 000000339.

8. NAMS Position Statement. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause 2022; 29 (7): 767–794. doi: 10.1097/GME.0000000000002 028.

9. Fournier A, Mesrine S, Boutron-Ruault MC et al. Estrogen-progestagen menopausal hormone therapy and breast cancer: does delay from menopause onset to treatment initiation influence risks? J Clin Oncol 2009; 27 (31): 5138–5143. doi: 10.1200/JCO.2008.21.6432.

10. Lähteenmäki P, Rauramo I, Backman T. The levonorgestrel intrauterine system in contraception. Steroids 2000; 65 (10–11): 693–697. doi: 10.1016/s0039-128x (00) 00176-8.

11. Westhoff CL, Keder LM, Gangestad A et al. Six-year contraceptive efficacy and continued safety of a levonorgestrel 52 mg intrauterine system. Contraception 2020; 101 (3): 159–161. doi: 10.1016/Contraception2019.10.010.

12. Creinin MD, Jensen JT. Extending use of levonorgestrel 52 mg intrauterine device to 8 years. Am J Obstet Gynecol 2023; 229 (1): 84. doi: 10.1016/j.ajog.2023.03.011.

13. Jiang W, Shen Q, Chen M et al. Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review. Steroids 2014; 86: 69–78. doi: 10.1016/j.steroids.2014.05.002.

14. Ueda Y, Kamiya CA, Horiuchi C et al. Safety and efficacy of a 52 mg levonorgestrel-realeasing intruterine system in women with carciovascular disease. J Clin Obstet Gynaecol Res 2019; 45 (2): 382–388. doi: 10.111/jog.13828.

15. Mittermeier T, Farrant C, Wise MR. Levonorgestrel-releasing intrauterine system for endometrial hyperplasia. Cochrane Database Syst Rev 2020; 9 (9): CD012658. doi: 10.1002/14651858.pub2.

16. Conz L, Mota BS, Bahamondes L et al. Levonorgestrel-releasing intrauterine system and breast cancer risk: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2020; 99 (8): 970–982. doi: 10.1111/aogs.13817.

17. Zürcher A, Knabben L, Janka H et al. Influence of the LNG-IUS on the risk of breast cancer: a systematic review. Arch Gynecol Obstet 2023; 307 (6): 1747–1761. doi: 10.1007/s00404-02206640y.

18. Jaakkola S, Lyytinen HK, Dyba T et al. Endometrial cancer associated with various forms of postmenopausal hormone therapy: a case control study. Int J Cancer 2011; 128 (7): 1644–1651. doi: 10.1002/ijc.25762.

19. Wan YL, Holland C. The efficacy of levonorgestrel intrauterine systems for endometrial protection: a systematic review. Climacteric 2011; 14 (6): 622–632. doi: 10.3109/13697137.2011.579650.

20. Varila E, Wahlström T, Rauramo I. A 5year follow-up study on the use of a levonorgestrel intrauterine system in women receiving hormone replacement therapy. Fertil Steril 2001; 76 (5): 969–973. doi: 10.1016/s0015-282 (01) 02846-1.

21. Suvanto-Luukkonen E, Malinen H, Sundström H et al. Endometrial morfology during hormone replacement therapy with estradiol gel combined to levonorgestrel-releasing intrauterine device or natural progesterone. Acta Obstet Gynecol Scand 1998; 77 (7): 758–763.

22. Andersson K, Stadberg E, Mattsson LA et al. Intrauterine or oral administration of levonorgestrel in combination with estradiol to perimenopausal women – effects on lipid metabolism during 12 months of treatment. Int J Fertil Menopausal Stud 1996; 41 (5): 476–483.

23. Wildemeersch D. Potential health benefits of continuous LNG-IUS combined with parenteral ERT for seamless menopausal transition and beyond – a commentary based on clinical experience. Gynecol Endocrinol 2013; 29 (6): 569–573. doi: 10.3109/09513590.2013.774364.

24. Stanczyk FZ, Shoupe D, Nunez V et al. A randomized comparison of nonoral estradiol delivery in postmenopausal women. Am J Obstet Gynecol 1988; 159 (6): 1540–1546. doi: 10.1016/0002-9378 (88) 90591-1.

25. Place VA, Powers M, Darley PE et al. A double--blind comparative study of Estraderm and Premarin in the amelioration of postmenopausal symptoms. Am J Obstet Gynecol 1985; 152 (8): 1092–1099. doi: 10.1016/0002-9378 (85) 90568x.

26. Hillard TC, Whitcroft SJ, Marsh MS et al. Long-term effects of transdermal and oral hormone replacement therapy on postmenopausal bone loss. Osteoporosis 1994; 4 (6): 341–348. doi: 10.1007/BF01622195.

27. Vrablik M, Fait T, Kovar J et al. Oral but not transdermal estrogen replacement therapy changes the composition of plasma lipoproteins. Metabolism 2008; 57 (8): 1088–1092. doi: 10.1016/j.metabol.2008.03.012.

28. Scarabin PY, Oger E, Plu-Bureau G. Differential association of oral and transdermal oestrogen replacement therapy with venous thromboembolism risk. Lancet 2003; 362 (9382): 428–432. doi: 10.1016/S0140-6736 (03) 14066-4.

29. Straczek C, Oger E, Yon de Jonage-Cano- nico MB et al. Prothrombotic mutations, hormone therapy, and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration. Circulation 2005; 112 (22): 3495–3500. doi: 10.1161/ CIRCULATIONAHA.105.565556.

30. Wu O. Postmenopausal hormone replacement therapy and venous tromboembolism. Gend Med 2005; 2 (Suppl A): S18–S27. doi: 10.1016/s1550-8579 (05) 80061-0.

31. Vinogradova Y, Coupland C, Hippisley-Cox J. Use of HRT and risk of venous tromboembolism: nested case-control studiex using the QResearch and CPRD databases. BMJ 2019; 364: k4810. doi: 10.1136/bmj.k4810.

32. Weller SC, Davis JW, Porterfiled L et al. Hormone exposure and venous thromboembolism in commercially insured women aged 50 to 64 years. Res Pract Thromb Haemost 2023; 7 (3): 100135. doi: 10.1016/j.rpth.2023.10 0135.

33. LaVasseur C, Neukam S, Kartika T et al. Hormonal therapies and venous thrombosis: considerations for prevention and management. Res Pract Thromb Haemostat 2022; 6 (6): e12763. doi: 10,1002/rth2.12763.

doc. MUDr. Tomáš Fait, Ph.D.
Gynekologicko-porodnická klinika
2. LF UK a FN Motol
V Úvalu 84
153 00 Praha 5
tfait@seznam.cz

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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Czech Gynaecology

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2024 Issue 2

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