Hair loss with use of the levonorgestrel intrauterine device

BackgroundThe levonorgestrel intrauterine device (IUD) has associated systemic side effects. However, there is little published information about the risk of alopecia.Study DesignReview of both the New Zealand Intensive Medicines Monitoring Programme (IMMP) data on alopecia associated with levonorgestrel IUD and the international evidence.MethodsThe IMMP uses Prescription Event Monitoring to study the safety of medicines during the postmarketing period. All reported cases of alopecia with levonorgestrel IUD use were identified in the IMMP databases and assessed for causality. World Health Organization (WHO) spontaneous reporting data were also obtained.ResultsFive reports of alopecia associated with the levonorgestrel IUD were identified in the IMMP database. From the cohort of insertions during 2000–2001, the estimated cumulative incidence of alopecia was 0.33% (95% CI 0.07–0.95) in the responder population. The WHO database contained a further 68 reports.ConclusionsCounselling prior to insertion of the levonorgestrel IUD should include information on systemic effects, including the possibility of alopecia.