Practical Recommendations on the Management of Issues Related to the Levonorgestrel 52mg Intrauterine System: A Delphi Panel: OAJBS Publishers

Practical Recommendations on the Management of Issues Related to the Levonorgestrel 52mg Intrauterine System: A Delphi Panel by Thais Emy Ushikusa* in Open Access Journal of Biomedical Science (OAJBS)


 

Objective: To gather the routine practice of Brazilian physicians with large experience on the Levonorgestrel 52mg intrauterine system (LNG IUS) use in order to generate practical recommendations on how to manage common aspects related to it.

Material and Methods: Twenty gynecologists with large experience with LNG IUS answered 39 questions grouped into five main topics: exams before the procedure, technical aspects of the device placement, practical recommendations, irregular bleeding, and pregnancy. A second round of questions was carried when responses were very divergent.

Results: Eighteen panelists responded to the questions. Recommendations that had more than 90% of agreement were i) the gynecological exam is the most important assessment before the insertion of LNG IUS; ii) in case of expulsion, a new device could be inserted; iii) there is no minimum age after menarche to use LNG IUS as a contraceptive, and iv) the device can be maintained after menopause. All the panelists responded that the duration of the insertion procedure was less than 10 minutes. Some topics did not reach more than 50% of agreement.

Conclusion: Most aspects related to LNG IUS usage reached an agreement in terms of clinical practices among physicians with different backgrounds, and also tend to correlate to the available guidelines. However, despite the availability of LNG IUS in Brazil for many years, there is still some disagreement regarding routine practices. There is a need for continuous education of physicians and the standardization of certain procedures to expand the use of this contraceptive method.
https://biomedscis.com/fulltext/practical-recommendations-on-the-management-of-issues-related-to-the-levonorgestrel-52mg-intrauterine-system-a-delphi-panel.ID.000347.php

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