Management of Bleeding and Spotting Associated with the LNG-IUS

The most common side effect associated with the levonorgestrel-releasing intrauterine system (LNG-IUS) is unpredictable bleeding and spotting, often leading to early discontinuation of this highly effective contraceptive method. In a placebo-controlled 12-week randomized trial, researchers evaluated the efficacy of naproxen sodium and transdermal estrogen in 129 LNG-IUS users who were recruited from the Contraceptive CHOICE Project (JW Womens Health May 12 2011). Participants in the oral regimen groups received either 500-mg naproxen or placebo twice daily for the first 5 days of each 4-week period, beginning at LNG-IUS insertion (Day 1). Participants in the third group received estradiol 0.1-mg patches beginning on Day 1 and replaced weekl…