The effect of levonorgestrel intrauterine system in the management of heavy menstrual and irregular vaginal bleeding

Abstract EN

Objective: To assess the effect of a Levonorgestrel releasing intrauterine system in the management of heavy and irregular menstrual bleeding.

Design: A prospective study.

Setting: The cases were collected from a private clinic in Dohuk city/ Kurdistan Region.

Methods: Sixty patients with a failed trial of medical therapy and awaiting hysterectomy were treated with a Levonorgestrel Intrauterine System (LNG-IUS).

The menstrual loss was estimated by the number of sanitary protection devices used and the degree of staining.

Further assessment was made by any concomitant menstrual clots, flooding and the associated dysmenorrhoea that affecting their life or job.

The follow- up was carried out at 3 months (first visit), 6 to 9 months (second visit) and up to 5 years period.

Results: Out of the 60 patients, 45 were pleased with the results of using the LNG-IUS.

There was no expulsion at the time of insertion.

During the follow-up, LNG-IUS was prematurely removed from 8 patients before the 1st visit due to different side effects (pain, backache, continuous vaginal bleeding) and 5 patients did not attend at all.

Around the end of the first year, 2 patients had their removal because of bleeding problems.

Most of the patients had unscheduled bleeding for six to eight weeks post-insertion.

Amenorrhoea was seen in 10 patients and the improvement of the premenstrual syndrome recorded in 70%, with a satisfaction rate of 75%.

The reduction in dysmenorrhoea was in 85% of the patients.

Conclusion: The LNG-IUS is an effective nonsurgical treatment for the management of heavy and irregular menstrual bleeding and dysmenorrhoea, with high rates of continuation and satisfaction, low rates of side-effects and complications that has an additional benefit as a contraceptive and in relieving of premenstrual syndrome.