TY - JOUR
T1 - Rate of and reason for discontinuation of levonorgestrel 13.5 mg intrauterine system as compared to levonorgestrel 52 mg intrauterine system and subsequent contraceptive choice at an academic medical center
AU - Cope, Adela G.
AU - Weaver, Amy L.
AU - Casey, Petra M.
N1 - Funding Information:
This study was made possible with funding from the Mayo Clinic Department of Obstetrics and Gynecology Research Committee.
Publisher Copyright:
© Journal of Reproductive Medicine®, Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - OBJECTIVE: To compare the rates of and reasons for discontinuation of levonorgestrel (LNG) 52 mg intra-uterine system (IUS) and LNG 13.5 mg IUS. STUDY DESIGN: In this retrospective cohort study, 81 premenopausal women aged 13–55 who underwent LNG 13.5 mg IUS insertion and 345 women who underwent LNG 52 mg IUS insertion from 1/1/2013 to 12/31/2015 were identi-fied. Baseline characteristics, symptom concerns, discon-tinuation rates, and subsequent contraception were compared. RESULTS: Women with LNG 13.5 mg IUS were significantly younger (mean age, 25.8 vs. 30.3 years), more likely to be nulliparous (87.7% vs. 28.0%), less likely to have previously used long-acting reversible contraception (12.3% vs. 35.4%), and had lower mean body mass index (25.1 vs. 27.1 kg/m2). In women with con-tact within 24 months, 54.8% (40/73) of women with LNG 13.5 mg IUS expressed symptom concerns, as compared to 60.1% (157/261) of women with LNG 52 mg IUS (p=0.41). By 24 months the cumulative incidence of discontinuation for symptom-related concerns was 20.4% (95% CI 9.8– 31.0%) and 13.9% (95% CI 9.5–18.3%) among women with LNG 13.5 mg IUS and LNG 52 mg IUS, respec-tively, taking into account other reasons for discontin-uation. CONCLUSION: While a lower proportion of LNG 13.5 mg IUS users expressed symptom concerns, the discontinuation rate due to symptom-related concerns by 24 months was higher in this group, though not significant statistical-ly.
AB - OBJECTIVE: To compare the rates of and reasons for discontinuation of levonorgestrel (LNG) 52 mg intra-uterine system (IUS) and LNG 13.5 mg IUS. STUDY DESIGN: In this retrospective cohort study, 81 premenopausal women aged 13–55 who underwent LNG 13.5 mg IUS insertion and 345 women who underwent LNG 52 mg IUS insertion from 1/1/2013 to 12/31/2015 were identi-fied. Baseline characteristics, symptom concerns, discon-tinuation rates, and subsequent contraception were compared. RESULTS: Women with LNG 13.5 mg IUS were significantly younger (mean age, 25.8 vs. 30.3 years), more likely to be nulliparous (87.7% vs. 28.0%), less likely to have previously used long-acting reversible contraception (12.3% vs. 35.4%), and had lower mean body mass index (25.1 vs. 27.1 kg/m2). In women with con-tact within 24 months, 54.8% (40/73) of women with LNG 13.5 mg IUS expressed symptom concerns, as compared to 60.1% (157/261) of women with LNG 52 mg IUS (p=0.41). By 24 months the cumulative incidence of discontinuation for symptom-related concerns was 20.4% (95% CI 9.8– 31.0%) and 13.9% (95% CI 9.5–18.3%) among women with LNG 13.5 mg IUS and LNG 52 mg IUS, respec-tively, taking into account other reasons for discontin-uation. CONCLUSION: While a lower proportion of LNG 13.5 mg IUS users expressed symptom concerns, the discontinuation rate due to symptom-related concerns by 24 months was higher in this group, though not significant statistical-ly.
KW - Contraception
KW - Intrauterine devices
KW - Levonorgestrel
KW - Long-acting reversible contracep-tion
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M3 - Article
AN - SCOPUS:85089832535
SN - 0024-7758
VL - 65
SP - 231
EP - 239
JO - Journal of Reproductive Medicine
JF - Journal of Reproductive Medicine
IS - 4
ER -