Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Decline in Danish use of oral tranexamic acid with increasing use of the levonorgestrel-releasing intrauterine system, A nationwide drug utilization study

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Contraceptive use at first intercourse is associated with subsequent sexual behaviors

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Questions to the LASS study group

    Research output: Contribution to journalLetterResearchpeer-review

  3. The INAS-OC study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Regional variation in out-of-hospital cardiac arrest: incidence and survival - a nationwide study of regions in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Socioeconomic position and one-year mortality risk among patients with heart failure: A nationwide register-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: To study patterns of oral tranexamic acid use among pre- and perimenopausal Danish women following the introduction of the levonorgestrel-releasing intrauterine system.

STUDY DESIGN: We conducted a nationwide descriptive drug utilization study including all 15-54-year-old Danish women during the period 1996-2017. National health registers provided information on use of oral tranexamic acid, the levonorgestrel-releasing intrauterine system, other hormonal contraceptives, and cyclical oral progestogens as well as incidence rates of endometrial ablations and hysterectomies. Linear calendar time trends in usage of these treatments were tested using Poisson and logistic regression models, which adjusted for user age and provided p-values for significance.

RESULTS: During the study period, use of the levonorgestrel-releasing intrauterine system increased 14-fold among women aged 15-54 years, from 2.3 in 1996 to 32 users per 1,000 person-years in 2017 (p<0.001). The increase happened consistently throughout the study period for women aged 20-54 years, but not for the youngest age group, 15-19 years, among whom the increase only happened in the end of study period following the introduction of a levonorgestrel-releasing intrauterine system with a smaller frame. Use of oral tranexamic acid declined from 11.3 in 1996 to 6.3 per 1,000 person-years in 2017 among women aged 20-54 years (p<0.001) but increased from 1.4 to 1.9 users per 1,000 person-years among those aged 15-19 years (p<0.001). Use of other hormonal contraceptives remained stable over time at around 300 users per 1,000 person-years, while the use of cyclical oral progestogens decreased from 4 to 0.1 users per 1,000 person-years (p<0.001). The incidence of hysterectomies decreased from 3.1 to 2.1 per 1,000 person-years (p<0.001), while the incidence rate of endometrial ablations increased from 0.7 to 1.3 per 1,000 person-years (p<0.001).

CONCLUSIONS: In Denmark, increasing use of the levonorgestrel-releasing intrauterine system has been accompanied by a decrease in use of oral tranexamic acid, cyclical oral progestogens, and hysterectomy.

IMPLICATION: Increasing use of the levonorgestrel-releasing intrauterine system was accompanied by declining use of other therapies used to decrease menstrual bleeding. The non-contraceptive benefits of hormonal contraception should be considered in cost-effectiveness analyses.

Original languageEnglish
JournalContraception
ISSN0010-7824
DOIs
Publication statusE-pub ahead of print - 11 Jan 2020

ID: 59053532