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Incidence of androgenic dermatologic side effects following placement of a levonorgestrel intrauterine device for menorrhagia: A survey-based study

Published:December 26, 2017DOI:https://doi.org/10.1016/j.jaad.2017.12.051
      To the Editor: Dermatologic manifestations of hyperandrogenic states include acne vulgaris, alopecia, and hirsutism and result from the excess stimulation of the pilosebaceous unit. A synthetic progestin, levonorgestrel, is a methyl testosterone derivative. When orally administered, it has been associated with acne, with a reported incidence between 5% and 20%.
      • Beck E.
      Progestin-only contraception.
      In contrast, given its localized effect, a levonorgestrel intrauterine device 52 mg (LNG-IUD) produces lower systemic levels of progestogens than with oral administration and, hence, is believed to have fewer systemic adverse effects. Existing literature has demonstrated the development of worsening acne in 6% of LNG-IUD users.

      ClinicalTrials.gov. Study in women with idiopathic menorrhagia to determine the reduction in menstrual blood loss (MBL) after treatment with the levonorgestrel-releasing intrauterine system (IUS). Available at: https://clinicaltrials.gov/ct2/show/study/NCT00360490. Identifier: NCT00360490. Accessed June 25, 2011.

      • Dubuisson J.B.
      • Mugnierb E.
      Acceptability of the levonorgestrel-releasing intrauterine system after discontinuation of previous contraception: results of a French clinical study in women aged 35 to 45 years.
      A more recent study found that 36% of hormone IUD users experienced worsened acne.
      • Lortscher D.
      • Admani S.
      • Satur N.
      • Erichenfield L.F.
      Hormonal contraceptives and acne: a retrospective analysis of 2147 patients.
      Given the wide use of LNG-IUD and the sparse data on this specific topic, this institutional review board–approved study sought to determine the incidence of skin-related hormonal side effects such as acne, hirsutism, and/or hair loss in women who had a LNG-IUD placed for the treatment of menorrhagia.
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      References

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      1. ClinicalTrials.gov. Study in women with idiopathic menorrhagia to determine the reduction in menstrual blood loss (MBL) after treatment with the levonorgestrel-releasing intrauterine system (IUS). Available at: https://clinicaltrials.gov/ct2/show/study/NCT00360490. Identifier: NCT00360490. Accessed June 25, 2011.

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        Hormonal contraceptives and acne: a retrospective analysis of 2147 patients.
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