Abstract
The levonorgestrel intrauterine system (LNG-IUS) has been used internationally for
over 15 years by 7 million women. Concern about providing the LNG-IUS to nulliparous
women still exists, despite growing evidence of its safety and efficacy in this population.
Expulsion rates do not vary by parity and, although evidence in nulliparas is scant,
perforation rates are low in all women. Efficacy of the LNG-IUS is excellent regardless
of parity, with less than 1 pregnancy per 100 woman-years of use. Efficacy with immediate
post-abortal insertion is also excellent and unvaried by parity. The presence of an
LNG-IUS does not increase the risk of PID or infertility in either parous or nulliparous
women and the LNG may be protective against infection. Acceptability is high in nulliparous
women when compared either to parous LNG-IUS users or to nulliparous users of combined
oral contraceptive pills.
In conclusion, LNG-IUS is both safe and extremely efficacious for use in nulliparous
women.
Keywords
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Article info
Publication history
Published online: April 05, 2007
Accepted:
January 24,
2007
Received in revised form:
January 22,
2007
Received:
December 4,
2006
Identification
Copyright
© 2007 Published by Elsevier Inc.
