Two Years Follow-Up of Patients with Abnormal Uterine Bleeding after Insertion of the Levonorgestrel-Releasing Intrauterine System

Gynecol Obstet Invest. 2018;83(6):569-575. doi: 10.1159/000480012. Epub 2017 Dec 8.

Abstract

Aim: To evaluate the efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) in the long-term treatment of heavy menstrual blood loss in women unrelated to intrauterine pathology.

Methods: One hundred and six parous women aged 33-48 years with recurrent heavy menstrual bleeding (HMB) participated in this study. The women were followed up for 24 months and were assessed for intensity of bleeding both for pre- and post-insertion periods. An LNG-IUS was inserted in each patient within 7 days of the start of menstrual flow. The women were followed up at 1, 3, 6, 12, 18, and 24 months following the insertion of the intrauterine device.

Results: One hundred and two women completed the follow-up period and had a significant reduction in the amount of menstrual blood loss. The LNG-IUS was well tolerated by all women. Pre-treatment of the use of the LNG-IUS, endometrial biopsy patterns for irregular proliferative endometrium and for atypical simple hyperplasia were 34/106 (32.08%) and 61/106 (57.55%) respectively and after treatment no abnormal pathologic findings were determined (p < 0.001).

Conclusion: Our findings indicate that the LNG-IUS is effective for significantly reducing the amount of menstrual blood loss in women with HMB.

Keywords: Endometrial biopsy.; Heavy menstrual bleeding; LNG-IUS; Levonorgestrel; Pulsatile index; Uterine volume.

MeSH terms

  • Adult
  • Contraceptive Agents, Female / administration & dosage*
  • Contraceptive Agents, Female / adverse effects
  • Endometrium / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Intrauterine Devices, Medicated / adverse effects*
  • Levonorgestrel / administration & dosage*
  • Levonorgestrel / adverse effects
  • Menorrhagia / therapy*
  • Menstruation / drug effects
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Turkey

Substances

  • Contraceptive Agents, Female
  • Levonorgestrel