Experience with the levonorgestrel-releasing intrauterine system among HIV-infected women☆☆☆
Received 27 April 2006; received in revised form 5 September 2006; accepted 6 September 2006. published online 30 October 2006.
Abstract
Background
Safe and effective contraception is needed for women infected with human immunodeficiency virus (HIV). The levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective long-term contraceptive that reduces menstrual bleeding and may reduce the risk of pelvic inflammatory disease. Yet, little is known about LNG-IUS use in HIV-infected women.
Subjects and Methods
Six HIV-infected women had the LNG-IUS inserted between March 1998 and October 2002, and were systemically followed for a mean of 45 months. Indications for LNG-IUS use were contraception in four women and menorrhagia in two women.
Results
The LNG-IUS was well tolerated, and menstrual bleeding was reduced in all women. Blood hemoglobin levels increased in each subject, with mean levels being 123 g/L (SD=11.7) before LNG-IUS insertion and 135 g/L (SD=8.7) at 1 year (p=.01). Levels of circulating CD4 lymphocytes and Pap smear findings remained unchanged.
Conclusions
Our limited experience with LNG-IUS use in HIV-infected women is encouraging. The LNG-IUS may be used as an alternative to uterine surgery in HIV-infected women with menorrhagia.
Department of Obstetrics and Gynecology, University of Helsinki, PO Box 140, SF-00029 Helsinki, Finland
Corresponding author. Fax: +358 9 47174801.
☆ Financial support from the University Central Hospital Research Funds is gratefully acknowledged. Dr. Heikinheimo is the recipient of a Finnish Medical Foundation Clinical Fellowship grant.
☆☆ The contents of the present manuscript do not necessarily reflect the policy of the funding sources.
ABSTRACT