DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190433

Impact of levonorgestrel intrauterine system on metabolic parameters

Arushi Singh, Poonam Mani, Shashi Prateek, Lalita Yadav, Eshna Gupta

Abstract


Background: Hormonal contraceptive is suggested to affect parameters like body mass index, body weight, blood pressure (BP), blood sugar, lipid protein, and liver function test (LFT) but effect of LNG-IUS on those parameters is still uncertain. The aim of the present study was to study the effects of LNG-IUS on the metabolic parameters.

Methods: Sixty women who opted for LNG-IUS for various indications were included in the study. Lipid profile, liver function tests (LFT), glucose levels [fasting and post prandial (PP)], and hemoglobin (Hb) were tested. Bimanual genital examination and transvaginal-ultrasonography was done prior to LNG-IUS insertion. Any problems observed were recorded. The subjects were re-evaluated after 6 and 9 months on their subsequent visits. Data were analyzed using paired “t” test. P value of <0.05 was considered statistically significant.

Results: Mean age of the patients was 35.5±6.79 years. Maximum number 50 (83.3%) had abnormal uterine bleeding (ovulatory dysfunction, endometrial, iatrogenic, not yet classified) [AUB (OEIN)]. Mean pictorial blood loss assessment chart (PBAC) score of patients was 164.7±56.72 and mean Hb level 11.15±1.75g/dL. LNG-IUS showed no significant adverse effects on anthropometric parameters at 6- and 9-month follow-up. Significant change was seen in total cholesterol (TC), very low-density lipoprotein (VLDL) and high density lipoproteins (HDL) values at follow-up (p<0.0001).

Conclusions: In conclusion, amongst Asian population, the LNG-IUS does not have any adverse effects on metabolic parameters, TGs, LDL and blood sugar levels.


Keywords


Body mass index, Lipid profile, Levonorgestrel-releasing intrauterine system, Weight gain

Full Text:

PDF

References


World Health Organization (WHO). 19th WHO Model List of Essential Medicines, Geneva; WHO 2015. Available at: http://www.who.int/medicines/publications/essentialmedicines/EML2015_8-May-15.pdf?ua = 1.

Kapp N, Abitbol JL, Mathé H, Scherrer B, Guillard H, Gainer E, et al. Effect of body weight and BMI on the efficacy of levonorgestrel emergency contraception. Contracept. 2014;91(2):97-104.

Arlıer S, Uysal G, Seyfettinoğlu S, Nazik H, Kaya FO. Effect of levonorgestrel-releasing intrauterine system on sexual and urinary functions. J Gynecol Res. 2017;3(2):202.

Gupta T, Gupta N, Gupta S, Bhatia P, Jain J, Kumar S. Levonorgestrel intrauterine system (LNG IUS) in menorrahgia: A follow-up study. Obstet Gynecol. 2014;4:190-6.

Geetha P, Chenchuprasad C, Sathyavathi RB, Bharathi T, Reddy SK, Reddy KK. Effect of socioeconomic conditions and lifestyles on menstrual characteristics among rural women. J Women’s Health Care. 2016;5:298.

Singh K, Bharati G, Prasad D, Kumari S. Role of levonorgestrel releasing intrauterine device in management of heavy menstrual bleeding: a conservative approach. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):631-5.

Bitzer J, Heikinheimo O, Nelson AL, Calaf-Alsina J, Fraser IS. Medical management of heavy menstrual bleeding: a comprehensive review of the literature. Obstet Gynecol Surv. 2015;70(2):115-30.

Jayanthi P, Sowjanya R. Efficacy and complications of levonorgestrel intrauterine system in heavy menstrual bleeding. IOSR-JDMS. 2017;16(12):38-41.

Vasaraudze I, Rezeberga D, Erts R, Lejnieks A. The influence of the levonorgestrel-releasing intrauterine system (LNG IUS) on metabolic markers in women with normal body mass and overweight women. Acta Chirurgica Latviensis. 2013;13:1.

Development of the LNG-IUS. Available at: http://www.icafoundation.org/ICA%20_LNG_manual.pdf.

Bender NM, Segall-Gutierrez P, Najera SO, Stanczyk FZ, Montoro M, Mishell DR Jr. Effects of progestin-only long-acting contraception on metabolic markers in obese women. Contracept. 2013;88(3):418-25.