Contraception With Subdermal Implants Releasing Levonorgestrel

Olsson, Sven-Eric

doi:10.3109/00016348709156486

Cited by 8 publications

(4 citation statements)

References 71 publications

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“…Previous studies in women using levonorgestrel-releasing implants, Norplant [13,14], for more than three years, showed that 20% of the women had luteinization of unruptured follicles (LUF). This is in agreement with the finding that low doses of progestogen-only methods induce abnormal follicular development [15].…”

Section: Discussionmentioning

confidence: 99%

Ovarian function after seven years' use of a levonorgestrel IUD

Barbosa

Odlind

et al. 1995

Adv Contracept

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Fifteen women with regular menstrual periods and seven amenorrheic women who had been using a levonorgestrel-releasing (LNg) IUD for more than seven years were studied. For controls, eight women using TCu380Ag IUDs for more than seven years were studied during two complete menstrual cycles. Ovarian function was assessed with hormonal determination and ultrasound examinations. The regularly menstruating women were studied for two complete menstrual cycles and the amenorrheic women for eight weeks. In the regularly menstruating LNg-IUD users, according to progesterone levels, 93% of the cycles were ovulatory but just 58% of these 'ovulatory' cycles showed normal follicular growth and rupture. Follicular cysts and luteinization of regressing follicles were observed in 42% of the 26 'ovulatory' cycles studied. SHBG capacity was decreased in the LNg-IUD users compared with the TCu380Ag users. Progesterone levels were lower in the LNg-IUD users compared with the TCu380Ag users but this difference was not statistically significant. Preovulatory estradiol and LH levels were lower in the LNg-IUD users than in the TCu380Ag users. These differences were not statistically significant. For the amenorrheic women, five had follicular cysts that disappeared spontaneously within 45 days. Two women showed follicular development and rupture. The presence of good cervical mucus was observed in 69% of the ovulatory cycles studied in the LNg-IUD users. This indicates that effects on cervical mucus cannot be the main mechanism of action of the LNg-IUDs. It is concluded that LNg-IUDs may exert a contraceptive effect in many different ways, such as inhibition of ovulation, endometrial changes preventing implantation, alteration of physical and chemical properties of cervical mucus affecting sperm transport and subtle disturbances in hypothalamic pituitary ovarian function, resulting in alterations of follicular development and rupture.

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Section: Discussionmentioning

confidence: 99%

Ovarian function after seven years' use of a levonorgestrel IUD

Barbosa

Odlind

et al. 1995

Adv Contracept

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“…The numbers of infrequent bleeding and amenorrhea episodes with Norplant-2 rods in the first year were lower than those with Norplant capsules in a one-year study, but prolonged bleeding with Norplant-2 was more frequent [13]. It could be associated with a higher rate of release of levonorgestrel from Norplant-2 rods compared to Norplant capsules in the first year of use [1].…”

Section: Discussionmentioning

confidence: 93%

“…Although there is a difference in the site of progestogen release of the two devices, serum concentrations of levonorgestrel are approximately similar during the first three years and episodes of breakthrough bleeding occur with both devices [1,2]. Since the two methods offer long-term contraceptive protection for at least three years and intrauterine devices are currently the major contraceptive method in China, it is necessary to investigate new methods of fertility control which may have better efficacy, lower side-effects and, hence, increased acceptability.…”

Section: Introductionmentioning

confidence: 99%

Three years' experience with levonorgestrel-releasing intrauterine device and Norplant-2 implants: a randomized comparative study

Wang

Xin³

et al. 1992

Adv Contracept

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A randomized comparative study of levonorgestrel-releasing intrauterine device (LNG-IUD) and Norplant-2 implants was carried out in 200 women for 36 months. Three thousand one hundred woman-months of use were observed with each device. Only one pregnancy occurred in users of LNG-IUD at the 12th month of use. The change in bleeding pattern was the most frequent reason for discontinuation. The discontinuation rate for irregular bleeding with Norplant-2 was 17.3 and 26.8 at 24 and 36 months, respectively, as compared to 3.3 with LNG-IUD at both 24 and 36 months. The differences were statistically significant. Removal for amenorrhea and pain only occurred in acceptors of LNG-IUD. About 20-40% of women using Norplant-2 had prolonged bleeding through 36 months. The percentage of amenorrhea in LNG-IUD was the highest (29.3%) at the end of two years of use. More than 97% of subjects reported satisfaction with the methods used by themselves.

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“…An important advantage of sustained-release, low-dose progestin contraception is their minimal metabolic effects. Studies of progestin implants have not detected changes outside of the normal range in carbohydrate metabolism, [61][62][63][64] liver function, [64][65][66][67][68] thyroid function, [69][70][71][72] adrenal function, 69,71,73,74 coagulation, 67,68,75,76 levels of immunoglobulins, 61,77 or blood chemistries. 61,66 Initial studies suggested a mild, although not clinically significant, decrease in insulin sensitivity in nondiabetic women.…”

Section: Minimal Metabolic Effectmentioning

confidence: 99%

Implant Contraception

Meckstroth¹,

Darney²

2001

Semin Reprod Med

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The experience of 6 million Norplant users has led to several more advanced implants. Implanon is a single-rod implant system containing a low androgenic progestin and requires 1 to 2 minutes for insertion and removal. Like other implants, Implanon prevents pregnancy by changing the character of the cervical mucus and interfering with luteal function. Unlike Norplant, though, Implanon is designed to prevent ovulation for the full duration of use. Implant contraception has several advantages over other types of contraception including high efficacy, minimal required maintenance, absence of estrogen, and rapid return of fertility after discontinuation. Implants can be a good choice for adolescents; women with hypertension, diabetes, anemia, endometriosis, or other medical problems; and women who are breast-feeding. Irregular bleeding is the most common adverse effect of implants and can be treated with several medication regimens. Preinsertion counseling, however, is the most important factor in ensuring satisfaction with implants. Unfortunately, no implant system is currently available in the United States since August 2000, but Implanon is expected to reach the U.S. market within the next 2 years.

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Contraception With Subdermal Implants Releasing Levonorgestrel

Cited by 8 publications

References 71 publications

Ovarian function after seven years' use of a levonorgestrel IUD

Ovarian function after seven years' use of a levonorgestrel IUD

Three years' experience with levonorgestrel-releasing intrauterine device and Norplant-2 implants: a randomized comparative study

Implant Contraception

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