Abstract Objective To evaluate the continuation rates of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) during the first 5 years of use, reasons for its discontinuation, bleeding patterns, and new contraceptive choice after the 5th year, in adolescents and young women. Methods The present study was a 5-year prospective cohort conducted in a Family Planning Service of a tertiary hospital in Brazil. We selected 100 healthy women between 15 and 24 years old who used 52-mg LNG-IUS for contraception. The clinical follow-up of these women took place from June 2017 to December 2022. The study evaluated the continuation rates of the method, reasons for its discontinuation, bleeding patterns, and new contraceptive choice after the 5th year. Continuous data were reported as mean ± standard deviation (SD) and range (minimum-maximum). Categorical variables were described as percentages. Results The continuation rates of LNG-IUS were 89.1% (82/92), 82.9% (72/87), 75.3% (64/85), 70.5% (60/85), and 64.2% (54/84) in the 1st, 2nd, 3rd, 4th, and 5th years of use, respectively. The main reason for discontinuation was acne (11/30). Amenorrhea rates were 50, 54.1, 39, 35.7, and 51.8% at 12, 24, 36, 48, and 60 months, respectively. All patients who completed the study and needed contraception after the 5th year opted for long-acting contraceptive methods (LARC). Conclusion The LNG-IUS showed high continuation rates in adolescents and young women in the first 5 years of use. Most patients who completed the study chose a LARC method after the 5th year. 52mg mg 52 levonorgestrelreleasing levonorgestrel releasing LNGIUS LNG IUS (LNG-IUS use patterns th 5year Brazil 10 1 2 followup follow up 201 2022 SD (SD minimummaximum. minimummaximum minimum maximum . (minimum-maximum) percentages 891 89 89.1 82/92, 8292 82/92 , 82 92 (82/92) 829 9 82.9 72/87, 7287 72/87 72 87 (72/87) 753 75 3 75.3 64/85, 6485 64/85 64 85 (64/85) 705 70 70.5 60/85, 6085 60/85 (60/85) 642 64.2 54/84 5484 54 84 (54/84 1st st 2nd nd 3rd rd 4th respectively 11/30. 1130 11/30 11 30 (11/30) 50 541 54.1 39 357 35 7 35.7 518 51 8 51.8 12 36 48 6 months longacting long acting LARC. (LARC) 20 202 (minimum-maximum 89. 82/9 (82/92 82. 728 72/8 (72/87 75. 648 64/8 (64/85 70. 608 60/8 (60/85 64. 54/8 548 (54/8 113 11/3 (11/30 54. 35. 51. 4 (LARC 82/ (82/9 72/ (72/8 64/ (64/8 60/ (60/8 54/ (54/ 11/ (11/3 (82/ (72/ (64/ (60/ (54 (11/ (82 (72 (64 (60 (5 (11 (8 (7 (6 ( (1
Resumo Objetivo Avaliar as taxas de continuação do sistema intrauterino liberador de levonorgestrel (SIU-LNG) 52 mg durante os primeiros 5 anos de uso, razões de sua descontinuação, padrões de sangramento e nova escolha contraceptiva após o 5° ano, em adolescentes e mulheres jovens. Métodos O estudo foi uma coorte prospectiva de 5 anos realizada em um Serviço de Planejamento Familiar de um hospital terciário no Brasil. Selecionamos 100 mulheres saudáveis entre 15 e 24 anos que usaram o SIU-LNG 52 mg para contracepção. O acompanhamento clínico dessas mulheres ocorreu de junho de 2017 a dezembro de 2022. O estudo avaliou as taxas de continuação do método, razões de sua descontinuação, padrões de sangramento e nova escolha contraceptiva após o 5° ano. Os dados contínuos foram relatados como média ± DP e intervalo (mínimo-máximo). As variáveis categóricas foram descritas como porcentagens. Resultados As taxas de continuação do SIU-LNG foram 89,1% (82/92), 82,9% (72/87), 75,3% (64/85), 70,5% (60/85) e 64,2% (54/84) no 1°, 2°, 3°, 4° e 5° anos de uso, respectivamente. O principal motivo de descontinuação foi a acne (11/30). As taxas de amenorreia foram de 50, 54,1, 39, 35,7 e 51,8% aos 12, 24, 36, 48 e 60 meses, respectivamente. Todas as pacientes que completaram o estudo e necessitaram de contracepção após o 5° ano optaram por métodos contraceptivos de longa duração (LARC). Conclusão O SIU-LNG apresentou altas taxas de continuação em adolescentes e mulheres jovens nos primeiros 5 anos de uso. A maioria das pacientes que completou o estudo escolheu um método LARC após o 5° ano. SIULNG SIU LNG (SIU-LNG uso Brasil 10 1 2 201 2022 mínimomáximo. mínimomáximo mínimo máximo . (mínimo-máximo) porcentagens 891 89 89,1 82/92, 8292 82/92 , 82 92 (82/92) 829 9 82,9 72/87, 7287 72/87 72 87 (72/87) 753 75 3 75,3 64/85, 6485 64/85 64 85 (64/85) 705 70 70,5 60/85 6085 (60/85 642 64,2 54/84 5484 54 84 (54/84 1° 2° 3° 4 respectivamente 11/30. 1130 11/30 11 30 (11/30) 50 541 54,1 39 357 35 7 35, 518 51 8 51,8 12 36 6 meses LARC. (LARC) 20 202 (mínimo-máximo 89, 82/9 (82/92 82, 728 72/8 (72/87 75, 648 64/8 (64/85 70, 60/8 608 (60/8 64, 54/8 548 (54/8 113 11/3 (11/30 54, 51, (LARC 82/ (82/9 72/ (72/8 64/ (64/8 60/ (60/ 54/ (54/ 11/ (11/3 (82/ (72/ (64/ (60 (54 (11/ (82 (72 (64 (6 (5 (11 (8 (7 ( (1