Ovarian cysts: Enlarged follicles (ovarian cysts) have been diagnosed in about 12% of the subjects using a hormonal IUD in studies that use ultrasound to look for cysts, even if asymptomatic. In studies that only evaluate symptomatic cysts, only 4.5% of women complain of any ovarian cysts over 5 or more years of use, and only 0.3% require IUD removal for ovarian cysts. Thus, any issues with ovarian cysts are not of a clinically relevant nature. Most of these follicles are asymptomatic, although some may be accompanied by pelvic pain or dyspareunia. In most cases the enlarged follicles disappear spontaneously after two to three months. Surgical intervention is not usually required. Mental health changes including: nervousness, depressed mood, mood swings
Weight gain
Headache, migraine
Nausea
Acne
Excessive hairiness
Lower abdominal or back pain
Decreased libido
Itching, redness or swelling of the vagina
Vaginal discharge
Breast pain, tenderness
Edema
Abdominal distension
Cervicitis
Bacterial vaginosis
May affect glucose tolerance
May experience a change in vision or contact lens tolerance
May deplete vitamin B1 which can affect energy, mood, and nervous system functioning
A "lost coil" occurs when the thread cannot be felt by a woman on routine checking and is not seen on speculum examination. Various thread collector devices or simple forceps may then be used to try to grasp the device through the cervix. In the rare cases when this is unsuccessful, an ultrasound scan may be arranged to check the position of the coil and exclude its perforation through into the abdominal cavity or its unrecognised previous expulsion.
Mechanisms of action
Levonorgestrel is a progestogen, i.e. a progesterone receptor agonist. The hormonal IUDs primary mechanism of action is to prevent fertilization. The levonorgestrel intrauterine system has several contraceptive effects, although thickening of the cervical mucus appears to be the primary effect. Other effects include making the inside of the uterus become fatal to sperm and thinning of the endometrial lining, but this is not the usual function.Ovulation is not inhibited in all cases.Numerous studies have demonstrated that IUDs primarily prevent fertilization, not implantation. In one experiment involving tubal flushing, fertilized eggs were found in half of women not using contraception, but no fertilized eggs were found in women using IUDs. IUDs also decrease the risk of ectopic pregnancy, which further implies that IUDs prevent fertilization. History
Hormonal IUDs were developed in the 1970s following the development of the copper IUD in the 1960s and 1970s. Dr. Antonio Scommenga, working at the Michael Reese Hospital in Chicago, discovered that administering progesterone inside the uterus could have contraceptive benefits. With knowledge of Scommegnas work, a Finnish doctor, Jouni Valter Tapani Luukkainen, created the T-shaped IUD that released progesterone, marketed as the Progestasert System in 1976. This IUD had a short, 1-year lifespan and never achieved widespread popularity.