Levonorgestrel

Definition - What does Levonorgestrel mean?

Levonorgestrel is a synthetic progestogen (female sex hormone) that has effects on ovulation, the endometrium (uterine tisue), and the cervical mucus. Progestogens often counter the effects of estrogens. Women's bodies naturally produce a balance of progestogens and estrogens that rise and fall during different stages of the menstrual cycle.

Levonorgestrel has labeled indications for contraception, emergency contraception, and menorrhagia (heavy menstrual bleeding). Often it is used to treat endometrial hyperplasia (the excessive thickening of the endometrium) and endometriosis (uterine lining found outside the uterus). Levonorgestrel is also used prior to in vitro fertilization (IVF) in women with polycystic ovary syndrome (PCOS) and simple endometrial hyperplasia (EH) to improve clinical pregnancy rate.

Levonorgestrel is available as an oral pill or intrauterine device (IUD).

FertilitySmarts explains Levonorgestrel

Endometrial hyperplasia is often caused by excess estrogen without progesterone. This leads to the uterine lining not being shed as the endometrium continues to grow, sometimes leading to cancer. Progestogen IUD's have been shown to reduce excessive endometrial growth and lessen relapse hyperplasia. In endometriosis, progestogens counter estrogen production reducing endometriosis tissue growth. Often pain symptoms are improved.

Progestogen IUD's when used for IVF are often prescribed for six months prior to embryo transfer with the intention of regulating the endometrial lining in preparation for implantation. Studies have shown this to be effective in increasing the chances of successful pregnancy in women with endometrial disorders.

Levonorgestrel IUDs are inserted by a healthcare professional. Bleeding and painful cramping may be present after. A woman may notice changes and lessening of her menstrual bleeding over time. Non-steroidal pain medication such as ibuprofen may be prescribed prior to and following insertion to lessen cramping.

Levonorgestrel pills used for contraception are prescribed or over-the-counter as one-step or two-step plans. They are most effective if taken within 72 hours of intercourse. Levonorgestrel is not effective if already pregnant. Patients may experience disrupted menstrual periods for a few months.

Common side effects of levonorgestrel include nausea, vomiting, headache, breast tenderness, dizziness, and abdominal pain. Rarely, ectopic pregnancy may occur. Patients should seek their doctor immediately if they experience abdominal pain three to five weeks after taking the oral form of levonorgestrel.

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