What are the adverse effects of the levonorgestrel-releasing intrauterine system?

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What are the adverse effects of the levonorgestrel-releasing intrauterine system?

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• The main initial adverse effect of the levonorgestrel-releasing intrauterine system is a change in bleeding pattern, which may become irregular or heavy at first. Women should be advised to persevere with treatment for a minimum of six cycles, as the benefit of treatment may not be seen until this point. • Progestogenic adverse effects, such as breast tenderness and mood changes, are not usually marked with the levonorgestrel-releasing intrauterine system, because only small amounts of hormone are released directly to their target of action (i.e. cervical mucous and endometrium). Functional ovarian cysts have occasionally been reported and normally resolve once treatment is stopped (ultrasound monitoring is recommended). • Other adverse effects reported include abdominal pain, peripheral oedema, pelvic pain, back pain, and, rarely, hirsutism or hair loss, migraine, rash, or itching.

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