Abstract | BACKGROUND: STUDY DESIGN: We searched the PubMed database for peer-reviewed articles relevant to IUD ( copper or levonorgestrel-releasing) use and uterine fibroids published in any language from database inception through June 2009. We used standard abstract forms and a grading system to summarize and assess the quality of the evidence. RESULTS: From 202 articles found in the database search, we identified 11 studies that met our inclusion criteria, all of which examined outcomes among users of the levonorgestrel-releasing IUD (LNG-IUD). Evidence from 10 of 11 noncomparative studies (Level II-3, fair) suggests that LNG-IUD use among women with fibroids does not increase menstrual bleeding, and results from all 11 showed that menstrual blood loss decreased among women who continued to use the LNG-IUD through the end of the study period. Overall, serum levels of hemoglobin, hematocrit and ferritin increased among LNG-IUD users in studies that assessed these outcomes. Several studies reported some occurrences of irregular bleeding. Findings from two cohort studies (Level II-2, fair to poor) showed rates of LNG-IUD expulsion to be higher among women with uterine fibroids (11% in each) than among women without uterine fibroids (0% and 3%); however, in one study the difference was not statistically significant, and in the other significance testing was not conducted. Six prospective noncomparative studies reported expulsion rates of 0-20% among women with uterine fibroids. CONCLUSIONS:
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Authors | Lauren B Zapata, Maura K Whiteman, Naomi K Tepper, Denise J Jamieson, Polly A Marchbanks, Kathryn M Curtis |
Journal | Contraception
(Contraception)
Vol. 82
Issue 1
Pg. 41-55
(Jul 2010)
ISSN: 1879-0518 [Electronic] United States |
PMID | 20682142
(Publication Type: Journal Article, Review, Systematic Review)
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Copyright | Published by Elsevier Inc. |
Chemical References |
- Contraceptive Agents, Female
- Hemoglobins
- Levonorgestrel
- Ferritins
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Topics |
- Contraceptive Agents, Female
(administration & dosage, adverse effects)
- Female
- Ferritins
(blood)
- Hematocrit
- Hemoglobins
(analysis)
- Humans
- Intrauterine Devices, Copper
(adverse effects)
- Intrauterine Devices, Medicated
(adverse effects)
- Leiomyoma
(complications, physiopathology)
- Levonorgestrel
(administration & dosage, adverse effects)
- Menorrhagia
(epidemiology, etiology)
- Uterine Hemorrhage
(epidemiology, etiology)
- Uterine Neoplasms
(complications, physiopathology)
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