[Levonorgestrel-releasing intrauterine system Mirena® (Bayer) for the prevention and treatment of endometrial adenocarcinoma and the incidence of other malignancies in women]

Ginekol Pol. 2015 Apr;86(4):305-10. doi: 10.17772/gp/2078.
[Article in Polish]

Abstract

The use of hormone-releasing intrauterine devices has been on the increase for the last three decades. To date, evidence of their long-term efficiency is available. The aim of the present paper was to briefly review beneficial prophylactic effects of the levonorgestrel-releasing intrauterine system on the incidence of a variety of malignancies in women. Such an influence is of a particular importance in the light of the currently observed increased prevalence of endometrial and cervical adenocarcinomas. Low-dose releasing intrauterine systems are also available, but the hard evidence-based medical data have been derived primarily for Mirena® (Bayer) device, which topically releases from 20 to 14 pg of levonorgestrel daily. Consequently the risk of developing endometrial carcinoma in Mirena® users is lowered by as much as 50% compared with the general population risk To a lesser extent, the intrauterine system decreases the risk for cervical adenocarcinoma and squamous cell carcinoma, as well as ovarian, pancreas, and lung carcinomas. In one population-based study Mirena® increased the risk for breast carcinoma by approximately 20%, whereas a number of other studies failed to demonstrate such a hazard. In the recent decades of the increased predominance of insulin resistance and obesity and an occurrence of hormone-dependent carcinomas at earlier age, a broad application of levonorgestrel-releasing intrauterine systems may become a particularly important component of primary prevention of malignancies in women. Both obese and overweight patients seem perfect candidates for such a hormonal intervention.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adenocarcinoma / prevention & control
  • Carcinoma, Endometrioid / prevention & control*
  • Contraceptive Agents, Female / adverse effects*
  • Endometrial Hyperplasia / prevention & control
  • Endometrial Neoplasms / prevention & control*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Intrauterine Devices, Medicated*
  • Levonorgestrel / administration & dosage*

Substances

  • Contraceptive Agents, Female
  • Levonorgestrel