Hormonal IUD for Endometriosis

Hormonal IUD (LNG-IUS) in Endometriosis – A Comprehensive Guide

What is a Hormonal IUD?

A hormonal IUD (LNG-IUS) is a system containing levonorgestrel and placed inside the uterus. It is used for birth control and in the treatment of certain gynecological conditions by providing long-term (typically 5 years) local hormone release.

Mechanism of Action in Endometriosis

The LNG-IUS creates a progesterone effect within the uterus, leading to thinning of the endometrial tissue. It reduces pelvic inflammation and alleviates pain symptoms. Systemic side effects are minimal.

In Which Patients Is It Used?

It is particularly preferred in patients with pelvic pain, those at risk of recurrence after surgery, and those desiring long-term treatment. It is also highly effective in patients with concomitant adenomyosis.

How Is It Applied?

It is inserted into the uterus during a gynecological examination. The procedure is brief and typically performed in an outpatient setting.

Advantages

Its most important advantages include its local effect, long-term use, no daily medication requirement, and no harm to ovarian reserve.

Effect on Pain

In many patients, it significantly reduces menstrual pain and chronic pelvic pain. The effect typically begins within a few months.

Side Effects

In the initial months, side effects such as irregular bleeding, spotting, and rarely headaches or acne may occur. These generally decrease over time.

Effect on Fertility

Fertility rapidly returns after the IUD is removed. It has no permanent effect.

When Is It Not Recommended?

It is not used in cases of uterine anomalies, active infection, and unexplained vaginal bleeding.

Post-Surgical Use

It is frequently recommended after endometriosis surgery to reduce recurrence and provides long-term protective effects.

Conclusion

The hormonal IUD is an effective, safe, and highly patient-compliant option for endometriosis treatment. It holds an important place, especially in long-term treatment plans.