Levosert (Levonorgestrel)

Levosert, a levonorgestrel‑releasing intrauterine system, provides long‑acting reversible contraception.

• Prevention of pregnancy: delivers a steady hormone dose to inhibit ovulation and prevent fertilisation for up to five years.
• Long‑acting reversible contraception: offers a convenient, hormone‑based method without daily dosing.
• Management of menstrual symptoms: can reduce heavy bleeding and dysmenorrhoea in users seeking hormonal regulation.

• Levonorgestrel released from the intrauterine system binds to progesterone receptors in the hypothalamus and pituitary, suppressing the luteinising hormone surge and thereby inhibiting ovulation. It also thickens cervical mucus, creating a barrier to sperm, and induces endometrial changes that reduce the likelihood of implantation.

Levosert may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Irregular vaginal bleeding: spotting or breakthrough bleeding, especially during the first months.
• Amenorrhoea: absence of menstrual periods after initial adjustment.
• Pelvic or abdominal pain: cramping associated with insertion or hormonal effects.
• Headache: mild to moderate intensity.
• Breast tenderness: hormonal‑related discomfort.
• Nausea: occasional gastrointestinal upset.

Serious or Rare Side Effects

• Uterine perforation: risk during insertion, requiring medical intervention.
• Expulsion of the device: partial or complete loss of the IUS.
• Pelvic infection: possible post‑insertion infection requiring antibiotics.
• Ectopic pregnancy: rare but serious if pregnancy occurs.
• Allergic reaction: rash, itching, or swelling at the insertion site.
• Hormone‑related thromboembolic events: extremely rare clotting disorders.

Before using Levosert, certain precautions should be observed to ensure safety and effectiveness.

• Screen for pregnancy: confirm the patient is not pregnant prior to insertion.
• Assess uterine anatomy: ensure the uterus is suitable for an intrauterine system.
• Check contraindications: avoid use in active pelvic infection, known or suspected malignancy, or unexplained vaginal bleeding.
• Monitor for device displacement: schedule follow‑up visits to verify correct positioning.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Levosert may interact with other medications that affect hormone metabolism or efficacy.

Major Interactions (Avoid)

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine, phenytoin): may reduce levonorgestrel levels.
• Rifampicin: can decrease hormonal effectiveness.
• Certain antiretrovirals (e.g., efavirenz): may lower contraceptive efficacy.

Moderate Interactions (Monitor Closely)

• Broad‑spectrum antibiotics (e.g., tetracycline): possible slight reduction in hormone levels.
• Herbal supplements such as St. John’s wort: may affect levonorgestrel metabolism.