Hemoglobin and serum ferritin levels in women using copper-releasing or levonorgestrel-releasing intrauterine devices: a systematic review

Richard F Lowe, Ndola Prata


The use of intrauterine devices as a contraceptive method has been steadily growing in developing countries. Anemia in reproductive-age women is a growing concern in those settings. A systematic review of studies with measured hemoglobin and serum ferritin at baseline and after 1 year of use of copper intrauterine devices (IUDs) or a levonorgestrel-releasing intrauterine system (LNG IUS) was performed. Fourteen studies involving copper IUDs in nonanemic women and 4 studies in anemic women and 6 involving the LNG IUS met the criteria for the systematic review. Meta-analyses for hemoglobin changes showed significant decreases for users of copper IUDs and an increase for the LNG IUS, but with limited data. In general, ferritin levels followed the same pattern. Decreases in hemoglobin mean values in copper IUD users were not sufficient to induce anemia in previously nonanemic women. Women who are borderline anemic would likely benefit from using the LNG IUS.


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Jun 7, 2017·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Lorenzo SabbioniStefano Luisi
Sep 11, 2018·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Geeta NandaRose Ngahu
Mar 8, 2016·Expert Opinion on Drug Delivery·Dirk WildemeerschThomas Hasskamp
Feb 19, 2021·Sexual and Reproductive Health Matters·Lucy C WilsonAmelia C L Mackenzie
Feb 6, 2021·Acta Obstetricia Et Gynecologica Scandinavica·Kristina Gemzell-DanielssonOskari Heikinheimo

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