Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors

Purpose: To estimate the 1-year continuation rate of low-dose levonorgestrel-releasing intrauterine systems (LNG-IUS) in Spanish women and elucidate potential factors impacting continuation. Materials and Methods: A prospective, multicenter, noninterventional study with a 1-year follow-up was conduc...

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Main Authors: Josep Perelló-Capó, Gregorio López-González, María Isabel Lahoz-Pascual, Ana Isabel López-Castejón, Manuel Marcos-Fernández, Mercedes Andeyro-García, Ignacio Cristóbal-García, Joan Rius-Tarruella
Format: Article
Language:English
Published: Mary Ann Liebert 2025-01-01
Series:Women's Health Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/whr.2024.0113
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author Josep Perelló-Capó
Gregorio López-González
María Isabel Lahoz-Pascual
Ana Isabel López-Castejón
Manuel Marcos-Fernández
Mercedes Andeyro-García
Ignacio Cristóbal-García
Joan Rius-Tarruella
author_facet Josep Perelló-Capó
Gregorio López-González
María Isabel Lahoz-Pascual
Ana Isabel López-Castejón
Manuel Marcos-Fernández
Mercedes Andeyro-García
Ignacio Cristóbal-García
Joan Rius-Tarruella
author_sort Josep Perelló-Capó
collection DOAJ
description Purpose: To estimate the 1-year continuation rate of low-dose levonorgestrel-releasing intrauterine systems (LNG-IUS) in Spanish women and elucidate potential factors impacting continuation. Materials and Methods: A prospective, multicenter, noninterventional study with a 1-year follow-up was conducted in Spain. Participants were 18–35-year-old women using low-dose LNG-IUS. Clinical and demographic data were collected, and the association between baseline characteristics and discontinuation rate was analyzed. Results: A total of 289 women (9.3% using 13.5 mg LNG-IUS and 90.6% using 19.5 mg LNG-IUS) completed the study, and 9% discontinued prematurely after 12 months. A statistically significant association was found between LNG-IUS discontinuation and educational level (odds ratio [OR] = 2.63; 95% confidence interval [CI]: 1.07–6.48), previous pregnancies (OR = 3.44; 95% CI: 1.40–8.46), and baseline intensity of menstrual pain (OR = 1.03; 95% CI: 1–1.04). In addition, both the change in the menstrual bleeding’s interference with daily life activities between the final and basal visit and the change in the pain associated with the intensity of menstrual bleeding showed a significant association with discontinuation. Conclusions: When recommending LNG-IUS, a patient’s baseline characteristics such as educational level, previous pregnancies, intensity of menstrual pain, and menstrual bleeding’s interference with daily life activities have to be considered. By doing so, health care providers can improve contraceptive counseling, reduce discontinuation rates, and enhance women’s satisfaction.
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spelling doaj-art-5416fce1255a4f38aee852bdf1e2ff2e2025-08-20T03:09:55ZengMary Ann LiebertWomen's Health Reports2688-48442025-01-016120922010.1089/whr.2024.0113Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing FactorsJosep Perelló-Capó0Gregorio López-González1María Isabel Lahoz-Pascual2Ana Isabel López-Castejón3Manuel Marcos-Fernández4Mercedes Andeyro-García5Ignacio Cristóbal-García6Joan Rius-Tarruella7Department of Paediatrics, Obstetrics and Gynaecology, Santa Creu i Sant Pau Universitary Hospital, Barcelona, Spain.Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain.Department of Obstetrics and Gynaecology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.Department of Obstetrics and Gynaecology, HM Hospitales, Madrid, Spain.Department of Obstetrics and Gynaecology, Hospital Universitario HM Montepríncipe, Madrid, Spain.Department of Obstetrics and Gynaecology, Hospital Universitario General de Villalba, Madrid, Spain.Department of Obstetrics and Gynaecology, Hospital Clínico San Carlos, Madrid, Spain.Medical Department, Medical Advisor Women Health, Bayer Hispania S.L., Barcelona, Spain.Purpose: To estimate the 1-year continuation rate of low-dose levonorgestrel-releasing intrauterine systems (LNG-IUS) in Spanish women and elucidate potential factors impacting continuation. Materials and Methods: A prospective, multicenter, noninterventional study with a 1-year follow-up was conducted in Spain. Participants were 18–35-year-old women using low-dose LNG-IUS. Clinical and demographic data were collected, and the association between baseline characteristics and discontinuation rate was analyzed. Results: A total of 289 women (9.3% using 13.5 mg LNG-IUS and 90.6% using 19.5 mg LNG-IUS) completed the study, and 9% discontinued prematurely after 12 months. A statistically significant association was found between LNG-IUS discontinuation and educational level (odds ratio [OR] = 2.63; 95% confidence interval [CI]: 1.07–6.48), previous pregnancies (OR = 3.44; 95% CI: 1.40–8.46), and baseline intensity of menstrual pain (OR = 1.03; 95% CI: 1–1.04). In addition, both the change in the menstrual bleeding’s interference with daily life activities between the final and basal visit and the change in the pain associated with the intensity of menstrual bleeding showed a significant association with discontinuation. Conclusions: When recommending LNG-IUS, a patient’s baseline characteristics such as educational level, previous pregnancies, intensity of menstrual pain, and menstrual bleeding’s interference with daily life activities have to be considered. By doing so, health care providers can improve contraceptive counseling, reduce discontinuation rates, and enhance women’s satisfaction.https://www.liebertpub.com/doi/10.1089/whr.2024.0113low-dose levonorgestrel-releasing intrauterine devicediscontinuation rateacceptabilitysatisfactionmenstrual bleeding patternreal-life data
spellingShingle Josep Perelló-Capó
Gregorio López-González
María Isabel Lahoz-Pascual
Ana Isabel López-Castejón
Manuel Marcos-Fernández
Mercedes Andeyro-García
Ignacio Cristóbal-García
Joan Rius-Tarruella
Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors
Women's Health Reports
low-dose levonorgestrel-releasing intrauterine device
discontinuation rate
acceptability
satisfaction
menstrual bleeding pattern
real-life data
title Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors
title_full Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors
title_fullStr Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors
title_full_unstemmed Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors
title_short Understanding Discontinuation Rates and Acceptance of the Low-Dose Levonorgestrel Intrauterine System in Spain: A Comprehensive Analysis of Bleeding Patterns and Influencing Factors
title_sort understanding discontinuation rates and acceptance of the low dose levonorgestrel intrauterine system in spain a comprehensive analysis of bleeding patterns and influencing factors
topic low-dose levonorgestrel-releasing intrauterine device
discontinuation rate
acceptability
satisfaction
menstrual bleeding pattern
real-life data
url https://www.liebertpub.com/doi/10.1089/whr.2024.0113
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