Use of the levonorgestrel-releasing intrauterine system, quality of life and sexuality. Experience in an Italian family planning center
Use of the levonorgestrel-releasing intrauterine system, quality of life and sexuality. Experience in an Italian family planning center
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DOI：
10.1016/j.contraception.2011.01.020
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发表时间：
2011-10-01
期刊：
影响因子：
2.9
通讯作者：
Benagiano, Giuseppe
中科院分区：
文献类型：
--
作者：
Bastianelli, Carlo;Farris, Manuela;Benagiano, Giuseppe
背景：左炔诺孕酮宫内缓释系统（LNG-IUS）于1990年首次在芬兰上市。自那时以来，它已在全世界约120个国家获得批准，迄今为止已积累了近5000万妇女年的经验。它的高避孕效果和有利的出血特征，导致特发性月经过多和正常月经出血的妇女月经出血显着减少，是该系统成功的关键。与此同时，需要为妇女提供足够的插入前咨询，了解月经出血的变化。在意大利的情况下，重要的是要强调在咨询期间，闭经是无害的，但可以导致健康的好处，如增加铁的血液储存和血液血红蛋白浓度。研究设计：评估避孕效果、依从性以及月经周期变化对LNG-IUS生活质量和性行为的影响（Mirena（R）），156名到计划生育诊所要求避孕的妇女参加了这项研究，并插入了该装置。虽然93.7%的妇女出现斑点，但大多数病例在6个月内消失。闭经发生在29.5%的所有妇女，发病的前六个周期后插入。来自EuroQuality of Life-5D和女性性功能指数问卷的数据显示，生活质量有所改善，性交相关疼痛减少，性欲有所改善。结论：尽管在意大利，宫内避孕的接受度很低，但一旦开始使用LNG-IUS，女性发现该装置代表了一种安全有效的避孕方式，具有宝贵的非避孕益处，特别是在大量或长期出血的情况下。(C)2011 Elsevier Inc. All rights reserved.
Background: The levonorgestrel-releasing intrauterine system (LNG-IUS) was first marketed in 1990 in Finland. Since then, it has been approved in approximately 120 countries throughout the world, with almost 50 million women-years of cumulative experience to date. Its high contraceptive effectiveness and favorable bleeding profile, leading to significant reduction of menstrual bleeding both in women with idiopathic menorrhagia and in those with normal menstrual bleedings, have been the key to the success of the system. At the same time, women need to be provided adequate preinsertion counseling about changes in menstrual bleeding to be expected. In the Italian context, it is important to highlight during counseling that amenorrhea is not harmful but can lead to health benefits such as an increase in iron blood stores and blood hemoglobin concentration.Study Design: To evaluate contraceptive efficacy, compliance and the effect of changes in menstrual cyclicity on quality of life and sexuality of the LNG-IUS (Mirena (R)), 156 women attending the Family Planning Clinic to request contraception were enrolled in the study and inserted with the device.Results: Menstrual blood flow decreased in all users, in terms of both quantity and duration; although spotting was present in 93.7% of the women, it disappeared within 6 months in the majority of cases. Amenorrhea occurred in 29.5% of all women, with onset within the first six cycles postinsertion. Data from the EuroQuality of Life-5D and Female Sexual Function Index questionnaires showed improvement in the quality of life, with a decrease in intercourse-related pain and an improvement in sexual desire.Conclusions: Although in Italy intrauterine contraception is poorly accepted, once started on LNG-IUS, women found that the device represents a safe and effective contraceptive modality, with valuable noncontraceptive benefits, especially in the presence of heavy or prolonged bleeding. (C) 2011 Elsevier Inc. All rights reserved.