November notes on important gynecology and obstetrics.

摘要

The progesterone containing intrauterine device has been one of the major advances in women's health during recent years and it's potentials are not yet fully exploited. With firmly Finnish origins, it is not only the contraceptive actions, but also the way it has changed the management of menstrual abnormalities during the later reproductive years (1), the positive impact in conditions such as endometrial hyperplasia or endometriosis and other sex-hormone conditioned indications (2), which has made it so important. Endometrial progesterone receptors seem to be down-regulated to be extent of becoming non-functional (3). Kristina Gemzell-Danielsson and her two co-authors write from Stockholm, Sweden, Berlin, Germany and Helsinki, Finland on pp. 1177-1188 on the current use of the levonorgestrel intrauterine system in a highly informative overview article. The use can clearly be extended and it is not only suitable for parous women as was generally assumed until recently. Not unlikely will we see refinements and extensions of the indications, a better understanding of direct effects on all uterine cell types and of the way the hormonal environment as a whole is affected.