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

Adela G. Cope, Amy L. Weaver, Petra M. Casey

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)231-239
Number of pages9
JournalJournal of Reproductive Medicine
Volume65
Issue number4
StatePublished - Jul 1 2020

Keywords

  • Contraception
  • Intrauterine devices
  • Levonorgestrel
  • Long-acting reversible contracep-tion

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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