The same is true for gonococcal infection.
The LNG-IUS in a woman taking tamoxifen
Tamoxifen is often prescribed for women who have estrogen-receptor–positive breast cancer. In the uterus and endometrium, tamoxifen acts as a partial estrogen agonist and is associated with an increased risk of endometrial polyps and endometrial cancer.
Placement of an LNG-IUS in a woman who is taking tamoxifen for breast cancer appears to reduce her risk of developing endometrial polyps. In a recently published trial, 113 women who had breast cancer and were taking tamoxifen were randomized to either 1) placement of an LNG-IUS plus endometrial surveillance (by transvaginal ultrasonography) or 2) endometrial surveillance only.11
After, on average, approximately 25 months of follow-up, new polyps arose in eight women who had not been assigned to have an LNG-IUS placed. New polyps arose in three women randomized to receive an LNG-IUS but, notably, none of those three had the LNG-IUS in place at the time the polyp was diagnosed: two, because they had had the device removed; one, because the device had, in fact, never been placed.
Emphasis on intrauterine contraception promises benefit for women
Every contraceptive option has its strengths and relative weaknesses. Barrier contraceptives, such as male and female condoms, for example, may reduce the risk of sexually transmitted disease but are sometimes used irregularly in real life—resulting in a high rate of unintended pregnancy.
Intrauterine contraception, on the other hand, very seldom results in unintended pregnancy. By increasing the use of IUC—to levels achieved in China, Turkey, and Western Europe—ObGyns in the United States would play a leadership role in what would likely be a reduction in unintended pregnancies. Such a shift would be an important development in women’s health.