Original research article| Volume 69, ISSUE 5, P407-412, May 2004

Download started.


Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study


      This 1-year randomized study was carried out at family-planning clinics of two university hospitals to compare the safety and acceptability of a levonorgestrel-releasing intrauterine system (LNG IUS) and oral contraceptives (OCs) in young nulliparous women. The study population consisted of 200 women aged 18–25 years seeking contraception. Ninety-four women entered the LNG IUS group and 99 entered the OC group. Continuation rates, reasons leading to discontinuation, adverse events, menstrual questionnaires, subjective well-being and sexual behavior were evaluated. Nineteen women (20%) in the LNG IUS group discontinued the study during the 1-year observation period, and 27 discontinued (27%) in the OC group. The most common reason (31%) for discontinuation in the IUS group was pain. In the OC group, hormonal side effects were the predominant medical reason for study termination. The safety and acceptability of the LNG IUS for contraception was observed to be as good as with OCs, with a high continuation rate.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Panser L.A.
        • Phipps W.R.
        Type of oral contraceptive in relation to acute, initial episodes of pelvic inflammatory disease.
        Contraception. 1991; 43: 91-99
        • Grodstein F.
        • Rothman K.J.
        Epidemiology of pelvic inflammatory disease.
        Epidemiology. 1994; 5: 234-242
        • Luukkainen T.
        • Nielsen N.-C.
        • Nygren K.-G.
        • Pyörälä T.
        Nulliparous women, IUD and pelvic infection.
        Ann Clin Res. 1979; 11: 121-124
        • Diaz J.
        • Pinto Neto A.M.
        • Bahamondes L.
        • Diaz M.
        • Arce X.E.
        • Castro S.
        Performance of copper T 200 in parous adolescents.
        Contraception. 1993; 48: 23-28
        • Toivonen J.
        • Luukkainen T.
        • Allonen H.
        Protective effect of intrauterine release of levonorgestrel on pelvic infection.
        Obstet Gynecol. 1991; 77: 261-264
        • Andersson K.
        • Odlind V.
        • Rybo G.
        Levonorgestrel releasing and copper releasing (Nova T) IUDs during five years of use. A randomized comparative study.
        Contraception. 1994; 49: 56-72
        • Milsom I.
        • Rybo G.
        • Lindstedt G.
        The influence of copper surface area on menstrual blood loss and iron status in women fitted with an IUD.
        Contraception. 1989; 41: 271-281
        • Bergkvist A.
        • Rybo G.
        Treatment of menorrhagia with intrauterine release of progesterone.
        Br J Obstet Gynaecol. 1983; 90: 255-258
        • Milsom I.
        • Andersson K.
        • Andersch B.
        • Rybo G.
        Comparison of flurbiprofen, tranexamic acid and a levonorgestrel-releasing intrauterine device in treatment of idiopathic menorrhagia.
        Am J Obstet Gynecol. 1991; 164: 879-883
        • Sivin I.
        • Stern J.
        • International Committee for Contraception Research
        Health during prolonged use of levonorgestrel 20 μg/d and copper TCu 380Ag intrauterine contraceptive devices.
        Fertil Steril. 1994; 61: 70-77
        • Suvisaari J.
        • Lähteenmäki P.
        Detailed analysis of menstrual bleeding patterns after postmenstrual and postabortal insertion of copper IUD or a levonorgestrel-releasing intrauterine system.
        Contraception. 1996; 54: 201-208
        • Belsey E.M.
        • Farley T.M.M.
        The analysis of menstrual bleeding patterns.
        Contraception. 1988; 38: 129-156
        • Sivin I.
        • El Mahgoub S.
        • McCarthy T.
        • et al.
        Long-term contraception with the levonorgestrel 20 mcg/day (LNG 20) and the copper T 380Ag intrauterine device.
        Contraception. 1990; 42: 361-378
      1. Andersson K. Intrauterine release of levonorgestrel, a contraceptive and therapeutical system. Thesis, University of Gothenburg, Sweden, 1993

        • Luukkainen T.
        • Allonen H.
        • Haukkamaa M.
        • et al.
        Effective contraception with the levonorgestrel-releasing intrauterine device.
        Contraception. 1987; 36: 160-179
        • Munday P.E.
        Clinical aspects of pelvic inflammatory disease.
        Hum Reprod. 1997; 12: 121-126
        • Weström L.
        Incidence, prevalence and trends of acute pelvic inflammatory disease and its consequences in industrialized countries.
        Am J Obstet Gynecol. 1980; 138: 880-892
        • Hubacher D.
        • Lara-Ricalde R.
        • Taylor D.J.
        • et al.
        Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women.
        N Engl J Med. 2001; 345: 561-567
        • Ness R.B.
        • Keder L.M.
        • Soper D.E.
        • et al.
        Oral contraception and the recognition of endometritis.
        Am J Obstet Gynecol. 1997; 176: 580-585
        • Henry-Suchet J.
        • Sluzhinska A.
        • Serfaty D.
        Chlamydia trachomatis screening in family-planning centers.
        Eur J Contracept Reproduct Health Care. 1996; 1: 301-309
        • Farley T.M.M.
        • Rosenberg M.J.
        • Rowe P.J.
        • Chen J.-H.
        • Meirik O.
        Intrauterine devices and pelvic inflammatory disease.
        Lancet. 1992; i: 785-788
        • Grimes D.A.
        • Schulz K.F.
        Prophylactic antibiotics for intrauterine device insertion.
        Contraception. 1999; 60: 57-63
        • den Tonkelaar I.
        • Oddens B.J.
        Preferred frequency and characteristics of menstrual bleeding in relation to reproductive status, oral contraceptive use, and hormone replacement therapy use.
        Contraception. 1999; 5: 357-362
        • Rosenberg M.J.
        • Waugh M.S.
        Oral contraceptive discontinuation.
        Am J Obstet Gynecol. 1998; 179: 577-582