Levosert Single-Handed Inserter (Levonorgestrel)

Levonorgestrel released from the intrauterine system acts on the reproductive hormonal pathway to provide contraception and treat menstrual disorders.

• Contraception: provides up to several years of highly effective pregnancy prevention for women of reproductive age.
• Heavy menstrual bleeding: reduces menstrual blood loss and improves anemia associated with excessive bleeding.
• Endometrial protection: suppresses endometrial proliferation, helping to maintain a thin, stable lining during use.

• Levonorgestrel released from the intrauterine system binds to progesterone receptors in the cervical epithelium, endometrium and hypothalamic‑pituitary axis. This action thickens cervical mucus, creates a hostile environment for sperm, inhibits endometrial growth, and suppresses the mid‑cycle luteinising hormone surge, thereby preventing ovulation and implantation. The device delivers a steady low dose over several years, maintaining local hormone concentrations while minimizing systemic exposure.

Levosert may be associated with a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Irregular bleeding or spotting
• Prolonged menstrual bleeding
• Amenorrhea (absence of periods)
• Breast tenderness

Serious or Rare Side Effects

• Uterine perforation during insertion
• Device expulsion or displacement
• Pelvic inflammatory disease or infection

Prior to insertion and during use, several precautions should be observed to ensure safety and effectiveness.

• Pregnancy testing: confirm the patient is not pregnant before insertion.
• Uterine assessment: evaluate cavity size and shape via ultrasound to ensure proper fit.
• History of pelvic infection: defer insertion if active infection is present.
• Smoking status: advise cessation, especially in women over 35, to reduce cardiovascular risk.
• Breastfeeding: discuss benefits and potential hormonal effects with the prescriber.
• Store at room temperature: keep the device in its original packaging, protect from moisture and direct sunlight.

Levonorgestrel released from an intrauterine system can have its efficacy altered by certain concomitant medications.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin, St. John’s wort): may reduce contraceptive effectiveness.
• Antiretroviral protease inhibitors: can lower levonorgestrel levels, increasing risk of unintended pregnancy.

Moderate Interactions (Monitor Closely)

• Antifungal azoles and some antibiotics: may modestly affect hormone metabolism.
• Herbal supplements affecting hormone balance (e.g., dong quai): monitor menstrual patterns.
• Hormonal therapies (e.g., estrogen patches): assess combined hormonal load.