Levonorgestrel Intrauterine System (LNG IUS) in Menorrahgia: A Follow-Up Study

Abstract

Objective: To study the acceptability, efficacy, adverse effect and user satisfaction of Levonorgestrel intrauterine system (LNG IUS) for treatment of menorrahgia. Method: This was an observational descriptive study conducted in ESI PGIMSR over a period from Jan 2008-June 2011. 70 women presented in O.P.D with heavy menstrual bleeding having no contraindication for device, consenting for LNG IUS underwent its insertion. Menstrual pattern, pictorial blood loss assessment chart score, adverse effects, and rate of acceptability and satisfaction were recorded at 3, 6 and 12 months after procedure. Results: The mean age of the sample was 39.92 yrs ± 3.27. Indication for device insertion was DUB in 81.42% (57), fibroid 8.57% (6), adenomyosis in 10% (7). The expulsion rate was 4.2% (3), removal rate was 7.14% (5) and continuation rate is 88.57% (62). 2.28% (3) patients underwent hysterectomy because of continuous bleeding even after 3 - 4 months of insertion. On follow-up at one year out of 62 patients, 33.87% (21) were amenorrhic and 51.61% (32) have regular period, while 3.07% (2) patients had irregular period. Conclusion: LNG IUS is a less invasive, effective treatment modality for menorrahgia with reasonable efficacy.

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Taru, G. , Nupur, G. , Sangeeta, G. , Pushpa, B. , Jyoti, J. and Sushma, K. (2014) Levonorgestrel Intrauterine System (LNG IUS) in Menorrahgia: A Follow-Up Study. Open Journal of Obstetrics and Gynecology, 4, 190-196. doi: 10.4236/ojog.2014.44032.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Shaw, R.W. (1994) Assessment of Medical Treatment for Menorrhagia. British Journal of Obstetrics and Gynaecology, 101, 8-15.
[2] Liu, Z., Doan, Q.V., Blumenthal, P. and Dubois, R.W. (2007) A Systematic Review Evaluating Health-Related Quality of Life, Work Impairment, and Health Care Costs and Utilization in Abnormal Uterine Bleeding. Value Health, 10, 183-194. http://dx.doi.org/10.1111/j.1524-4733.2007.00168.x
[3] Stewart, A., Cummins, C., Gold, L., Jordan, R. and Phillips, W. (2001) The Effectiveness of the Levonorgestrel-Releasing Intrauterine System in Menorrhagia: A Systematic Review. British Journal of Obstetrics and Gynaecology, 108, 74-86. http://dx.doi.org/10.1016/S0306-5456(00)00020-6
[4] Chimbira, T.H., Anderson, A.B. and Turnbull, A.C. (1980) Relation between Measured Menstrual Blood Loss and Patient’s Subjective Measurement of Loss, Duration of Bleeding, Number of Sanitary Towels Used, Uterine Weight and Endometrial Surface Area. British Journal of Obstetrics and Gynaecology, 87, 603-609. http://dx.doi.org/10.1111/j.1471-0528.1980.tb05013.x
[5] Monteiro, I., Bahamondes, L., Diaz, J., Perrotti, M. and Petta, C. (2002) Therapeutic Use of Levonorgestrel-Releasing Intrauterine System in Women with Menorrhagia: A Pilot Study. Contraception, 65, 325-328. http://dx.doi.org/10.1016/S0010-7824(02)00283-4
[6] National Collaborating Centre for Women’s and Children’s Health (2007) Heavy Menstrual Bleeding. Clinical Guideline January. Commissioned by the National Institute for Health and Clinical Excellence.
[7] Nagrani, R., Bowen-Simpkins, P. and Barrington, J.W. (2002) Can the Levonorgestrel System Replace Surgical Treatment for the Management of Menorrhagia? BJOG, 109, 345-347.
http://dx.doi.org/10.1111/j.1471-0528.2002.01274.x
[8] Latheenmakhi, P., Haukkamaa, M. and Paullaka, J. (1998) Open Randomized Study of LNG Intrauterine System as Alternative to Hysterectomy. BMJ, 316, 122-125.
[9] Luukkainen, T. (2000) The Levonorgestrel Intrauterine System: Therapeutic Aspects. Steroids, 65, 699-702. http://dx.doi.org/10.1016/S0039-128X(00)00177-X
[10] Hurskainen, R., Teperi, J., Rissanen, P., et al. (2004) Clinical Outcomes and the Costs with the Levonorgestrel Releasing Interuterine System or Hysterectomy for Treatment of Menorrhagia. JAMA, 291, 1456-1463. http://dx.doi.org/10.1001/jama.291.12.1456
[11] World Health Organization (2008) Medical Eligibility Criteria for Contraceptive Use. WHO, Geneva.
[12] Chattopdhyay (2011) Clinical Outcome of Levonorgestrel Intrauterine System in Idiopathic Menorrhagia. European Journal, 15, 764-768.
[13] Kaunitz, A.M., Bissonnette, F. and Monteiro, I. (2010) Levonorgestrel Releasing Intrauterine System or Medroxy Progestrone for Heavy Menstrual Bleeding: A Randomized Controlled Trial. Obstetrics & Gynecology, 116, 625-632.
[14] Endrikat, J., Shapirott and Lukkari-lax, E. (2009) A Canadian Multicentre Study Comparing the Efficacy of a Levonorgestrel Releasing Intrauterine System to an Oral Contraceptive in Women with Idiopathic Menorrhagia. Journal of Obstetrics and Gynaecology Canada, 31, 340-347.
[15] Utman, et al. (2012) Levonorgestrol IUS in Menorrhagia. A Three Years Follow Up Study. JPMI, 96, 79-83.
[16] Xiao, B., Wu, S.C. and Chang, J. (2003) Therapeutic Effects of the Levonorgestrel Releasing Intrauterine System in the Treatment of Idiopathic Menorrhagia. Fertility and Sterility, 79, 963-969.
[17] Grigorieva, V., Chen-Mok, M., Tarasova, M., et al. (2003) Use of Levonorgestrel Releasing Intrauterine System to Treat Bleeding Related to Uterine Leiomyomas. Fertility and Sterility, 79, 1194-1198. http://dx.doi.org/10.1016/S0015-0282(03)00175-4
[18] Sushil, et al. (2005) Therapeutic Use of LNG Intrauterine System for Menorrhagia Due to Benign Lesion—An Alternative to Hysterectomy? The Journal of Obstetrics and Gynecology of India, 55, 541-543.
[19] Reid, P.C. and Virtanen-Kari, S. (2005) Randomised Comparative Trial of the Levonorgestrel Intrauterine System and Mefenamic Acid for the Treatment of Idiopathic Menorrhagia; A Multiple Analysis Using Total Menstrual Blood Loss and Pictorial Blood Assessment Charts. British Journal of Obstetrics and Gynaecology, 112, 112-115.
[20] Kriplani, A., Singh, B.M. and Lal, S. (2007) Efficacy, Acceptability and Side Effects of LNG IUS for Menorrhagia. International Journal of Gynecology & Obstetrics, 97, 190-194.

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