(129) A Prospective Study of the Impact of Levonorgestrel Intrauterine Devices on Sexual and Bladder Health
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction Intrauterine devices (IUDs) are among the most effective and widely used contraceptive methods worldwide, with levonorgestrel-releasing IUDs (Lng-IUDs) being the most common. As use increases, concerns have emerged regarding potential effects on women’s bladder and sexual health. Oral contraceptive pills have been associated with urinary urgency and painful bladder syndrome, likely due to reduced androgen and estrogen levels and diminished estrogen responsiveness. Given the local progestin effects of Lng-IUDs and decreased estrogen receptor density in pelvic tissues, it is possible that similar bladder and sexual side effects could occur among Lng-IUD users. Despite these plausible mechanisms, evidence remains limited and inconsistent, and prospective U.S. data using validated questionnaires are lacking. Objective To prospectively evaluate the impact of Lng-IUDs on bladder and sexual function using validated instruments, addressing a key gap in domestic research on Lng-IUDs to guide evidence-based counseling for patients. Methods Women aged 18–45 presenting to a high-volume tertiary gynecologic center for initial Lng-IUD placement were prospectively enrolled. Exclusion criteria included being within six months postpartum, currently breastfeeding, or undergoing IUD exchange. Recruitment and consent were obtained by phone within one week of placement, and data were managed using REDCap. Participants completed standardized electronic questionnaires within one week and again at six months post-placement, assessing sexual function and lower urinary tract symptoms using the Female Sexual Function Index (FSFI) and the Urinary Distress Inventory, Short Form (UDI-6). Statistical analyses were performed using paired t-tests. Results Sixty-five women were enrolled, and 54 (83%) completed both baseline and six-month surveys. Most participants received the Mirena IUD (83%), while 17% received the Kyleena. The mean age was 29 ± 2 years, and participants were predominantly White (75%), followed by Black or African American (19%), and Asian (5%). The mean BMI was 30.3 ± 7.5 kg/m2. Forty percent were single, 31% married, and 19% in a relationship. The mean number of prior pregnancies was 1 ± 1.7. Indications for placement included contraception (48%), irregular or painful menses (25%), and menorrhagia (44%). No significant change was observed in UDI-6 scores from pre-placement (16.05 ± 18.66) to six months post-placement (14.06 ± 15.62), t(53) = −0.94, p = 0.35 (Fig. 1). Similarly, FSFI scores did not significantly change from pre-placement (21.47 ± 8.34) to post-placement (20.47 ± 10.17), t(53) = −0.84, p = 0.41 (Fig. 2). Conclusions Results demonstrate stability in both bladder and sexual function following Lng-IUD placement, with no significant changes observed in UDI-6 or FSFI scores over six months. These findings contribute valuable prospective, U.S.-based data to a divided body of literature. The absence of detrimental effects on bladder and sexual health may offer reassurance to patients concerned about the side-effect profile of hormonal IUDs. Disclosure No.
Source: Proceedings of IMPRS
Institutions: Indiana University School of Medicine, Indiana University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413445767