Recent advancements and future applications of intrauterine drug delivery systems.

Introduction: Intrauterine devices (IUDs) are drug-device combination products that are placed inside the uterus above the endometrium. IUDs contain a therapeutic agent used for contraception and have been shown to have other therapeutic benefits. Over the past century, intrauterine drug delivery systems (IUDDS) have revolutionized women's health, and they hold immense growth potential in the future for new developments in the therapeutic areas beyond contraception.

Areas covered: The aim of this review is to offer a comprehensive description of the history, development, and current state of IUDDS, next-generation IUDDS, and future applications of IUDDS in therapeutic areas beyond contraception such as multi-purpose prevention technologies, hormone replacement therapy, endometriosis, uterine fibroids, and endometrial cancer.

Expert opinion: The uterus's unique features make it an ideal site for controlled, prolonged, and localized delivery of drugs, ensuring maximum concentration at the target site. Currently, IUDs are the most widely used contraceptive method. Future IUDDS hold the potential to deliver therapeutic agents for broader therapeutic areas for women's health, potentially aiding in the treatment of various diseases and disorders of the female reproductive system. Further research in development, characterization, and translation is warranted to ensure IUDDS reach their potential in many areas of women's health.