Background: The levonorgestrel intrauterine device (IUD) has associated systemic side effects. However, there is little published information about the risk of alopecia.
Study design: Review of both the New Zealand Intensive Medicines Monitoring Programme (IMMP) data on alopecia associated with levonorgestrel IUD and the international evidence.
Methods: The 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.
Results: Five 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.
Conclusions: Counselling prior to insertion of the levonorgestrel IUD should include information on systemic effects, including the possibility of alopecia.