Vol 86, No 4 (2015)
ARTICLES
Levonorgestrel-releasing intrauterine system Mirena® (Bayer)
for the prevention and treatment of endometrial adenocarcinoma
and the incidence of other malignancies in women
Maciej Jóźwik, Marcin Jóźwik, Beata Modzelewska, Marta Niewińska, Michał Jóźwik
DOI: 10.17772/gp/2078
·
Ginekol Pol 2015;86(4).
Vol 86, No 4 (2015)
ARTICLES
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 μg 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 levonorgestrelreleasing
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.
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 μg 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 levonorgestrelreleasing
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.
Keywords
endometrial neoplasms / intrauterine devices / levonorgestrel /
/ uterine cervical neoplasms /
Title
Levonorgestrel-releasing intrauterine system Mirena® (Bayer)
for the prevention and treatment of endometrial adenocarcinoma
and the incidence of other malignancies in women
Journal
Ginekologia Polska
Issue
Vol 86, No 4 (2015)
Page views
1262
Article views/downloads
12403
DOI
10.17772/gp/2078
Bibliographic record
Ginekol Pol 2015;86(4).
Keywords
endometrial neoplasms / intrauterine devices / levonorgestrel /
/ uterine cervical neoplasms /
Authors
Maciej Jóźwik
Marcin Jóźwik
Beata Modzelewska
Marta Niewińska
Michał Jóźwik