Levonorgestrel-releasing intrauterine device used for dysmenorrhea: five-year literature review

Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing IUD (LNG-IUD), originally designed for long-term contraceptives, is now recognized to provide non-contraceptive health benefits. These include severe dysmenorrhea and/or heavy menstrual bleeding associated with uterine myoma, endometriosis, and adenomyosis. This report aims to review the last five-year literature on the efficacy and safety of the LNG-IUD in women with dysmenorrhea. Dysmenorrhea has been reported to decrease in all women. LNG-IUD seems to be superior over copper-releasing IUD for improving dysmenorrhea. The LNG-IUD is beneficial for symptom recurrence and endometriotic cyst recurrence after conservative surgery for patients with severe pain related to endometriosis. There is also evidence to support its role in menstrual problems of severely obese adolescent females. Expulsion, one of the important factors for IUD acceptability, is rare but more common in women with distorted uterine cavity. In the treatment of dysmenorrhea, the LNG-IUD is equal or superior to treat with systemic progestins or oral contraceptives even in adolescent or menopausal women.