Use of Levo - Norgestrel releasing, intrauterine contraceptive device is helpful in all of the following conditions except :

Ans. is c i.e. Premenstrual symptoms Levonorgestrel releasing intra uterine contraceptive device know as MIRENA is third generation IUCD. It contains 52mg of LNG dispersed in polydimethylsiloxane and released at a rate of 20pg per day. Main mechanism of action : Makes endometrium non receptive. "The Levonorgestrel IUD lasts upto 10 years and reduces menstrual blood loss and pelvic infection rates. Indeed the levonorgestrel IUD is about as effective as endometrial ablation for the treatment of menorrhagia. The local progestin effect directed to the endometrium can be utilized in patient on tamoxifen, patients with dysmenorrhea and in postmenopausal women receiving estrogen therapy". Non contraceptive uses of LNG Containing IUCD : Decrease menstrual blood loss and are used for management of menorrhagia. Significant reduction in dysmenorrhea.deg Decreases pelvic infection ratesdeg. Can be used in treatment of endometrial hyperplasia. adenomyosis, uterine leiomyomas and endometrial cancer. Provides the benefits of hormone replacement therapy when used over the transition years of reproduction to perimenopause. As far as premenstrual tension syndrome (PMS) is concerned Dutta Obs 6/e p 541 say it is relieved by LNG- IUCD but is not suppoed elsewhere. Advantages of 3rd generation IUCD over other IUCD's : High efficacy with low pregnancy rates. Longer duration of action Low expulsion rates Can be given to nursing mothers. Also know : Other hormone releasing IUCD's : Progestase - It carries 38mg of progesterone and releases 65.ig of hormone per day. - It is expressive and requires yearly replacement. Levonova : - It has 60mg of levonorgestrel and releases 20pg of hormone per day. It is used for 5 years. Note : Progesterone releasing IUCDs are a/w ectopic pregnancy.