A nationwide cohort study of the use of the levonorgestrel intrauterine device in New Zealand adolescents

Background: While the use of the levonorgestrel intrauterine device (LNG-IUD) is well established in the adult population, there have been no research studies specifically on the use of the LNG-IUD in adolescents. Study Design: A nationwide cohort study of 179 adolescents in New Zealand using the LNG-IUD, by means of a follow-up questionnaire to their practitioner, was conducted to determine the indications for insertion of the LNG-IUD and to establish patterns of use, including duration of use and reasons for removal. Results: The study, with a 94% response rate, demonstrated that the most common indication for use was menorrhagia (17%); 29% of adolescents had an off-label primary indication. There was a 1-year continuation rate of 85%. The cumulative incidence of expulsion was 8%. Conclusion: The results of this study should be reassuring for practitioners and adolescents considering use of the LNG-IUD. However, further research is required into the safety and efficacy of the LNG-IUD in adolescents especially in the management of off-label indications. (C) 2009 Elsevier Inc. All rights reserved.