Abstract | OBJECTIVE: DESIGN: A systematic review and meta-analysis of randomised controlled trials. IDENTIFICATION: Studies were identified through seven databases, and by contacting investigators and organisations working in the contraceptive field. MAIN OUTCOME MEASURES: RESULTS: Five of the seven randomised controlled trials which met the inclusion criteria were included in the meta-analyses; four were comparisons of the LNG-20 intrauterine system with nonhormonal intrauterine devices. LNG-20 intrauterine systems were compared with intrauterine devices divided into two categories, those > 250 mm3 ( Copper T 380 Ag and Copper T 380A intrauterine devices) and those < or = 250 mm3 (Nova-T, Copper T 220C and Copper 200 intrauterine devices). Pregnancy rates for the LNG-20 intrauterine system users were significantly less likely to become pregnant compared with users of intrauterine devices < or = 250 mm3, and significantly less likely to have an ectopic pregnancy. LNG-20 intrauterine system users were more likely to experience amenorrhoea and device expulsion than women using intrauterine devices > 250 mm3. LNG-20 intrauterine system users were significantly more likely than all the intrauterine device users to discontinue because of hormonal side effects and amenorrhoea. When the LNG-20 intrauterine system was compared with Norplant-2, the LNG-20 users were significantly more likely to experience oligo-amenorrhoea, but significantly less likely to experience prolonged bleeding and spotting. CONCLUSIONS: The effectiveness of the LNG-20 intrauterine system was similar to or better than other contraceptive methods with which it was compared. Amenorrhoea was the main reason for the discontinuation of the LNG-20 intrauterine system, usually unnecessarily, since this end-organ suppression of bleeding is benign, associated with normal oestrogen levels. Women choosing this method should be informed of potential amenorrhoea when having pre- contraceptive counselling and that absent bleeding may be viewed as a positive outcome.
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Authors | R S French, F M Cowan, D Mansour, J P Higgins, A Robinson, T Procter, S Morris, J Guillebaud |
Journal | BJOG : an international journal of obstetrics and gynaecology
(BJOG)
Vol. 107
Issue 10
Pg. 1218-25
(Oct 2000)
ISSN: 1470-0328 [Print] England |
PMID | 11028571
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Chemical References |
- Contraceptive Agents, Female
- Levonorgestrel
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Topics |
- Contraception
(methods)
- Contraceptive Agents, Female
(administration & dosage, adverse effects)
- Counseling
- Female
- Humans
- Intrauterine Devices, Medicated
- Levonorgestrel
(administration & dosage, adverse effects)
- Menstruation Disturbances
(chemically induced)
- Meta-Analysis as Topic
- Randomized Controlled Trials as Topic
- Risk Factors
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