左炔诺孕酮宫内缓释系统的非避孕应用

左炔诺孕酮宫内缓释系统(delayed levonorgestrel-releasing intrauterine system,LNG-IUS)是90年代上市的新型避孕系统(商品名:曼月乐),其通过每天释放20μg的左炔诺孕酮至宫腔,使子宫内膜腺体萎缩、间质蜕膜样变、黏膜变薄,实现孕激素的非全身给药,应用于月经过多、子宫内膜异位症和子宫腺肌病、子宫肌瘤、激素替代治疗期间的子宫内膜保护及子宫内膜增生和早期的子宫内膜癌等,从而开辟了在非避孕领域的许多新的应用。

Non-contraceptive therapeutic uses of Levonorgestrel releasing-intrauterine systems

Levonorgestrel releasing-intrauterine systems(LNG-IUS,the Mirena)were originally developed as a method of contraception in the mid 1990s which released 20 ug of levonorgestrel per day directly into the uterine cavity.Research into the non-contraceptive uses of LNG-IUS was rapidly expanding.LNG-IUS was licensed for use in menorrhagia and to provide endometrial protection to perimenopausal and postmenopausal women on estrogen replacement therapy.There was limited evidence to suggest that LNG-IUS may also be beneficial for women with endometriosis,adenomyomatosis,hysteromyoma,endometrial hyperplasia and early stage endometrial cancer.This review evaluated the quality of evidence relating to the non-contraceptive therapeutic uses of LNG-IUS in gynaecology.