Objectives: To evaluate short-term outcome of the use of Levonorgestrel-releasing intrauterine system (LNG-IUS) for management of menorrhagia in women in the childbearing period
Patients & Methods: The study included 53 multipara women with mean age of 39.4±4 years presenting with menorrhagia. All women had full history taking, clinical examination, transvaginal ultrasonography and endometrial biopsy and cervical smear evaluation prior to LNG-IUS insertion one day after cessation of menstrual bleeding. Patients were evaluated at 6 and 12 months for duration and heaviness of menstrual blood loss and for health-related quality of life was evaluated using the 5-Dimensional EuroQol (EQ-5D) scoring system.
Results: Nine insertions were difficult; 7 because of pain on sounding and 2 insertions were abandoned because of the presence of cervical adhesions. There were 3 IUS expulsions; two partial and a new IUS was reinserted and one complete expulsion and patient was excluded of the study. LNG-IUS significantly reduced duration and severity of blood loss at 6 and 12 months after insertion compared to baseline data with significant reduction at 12 months compared to at 6 months. At the end of 12 months; 7 women developed amenorrhea, 36 women had mild loss and 7 women had moderate loss. Quality of life scoring significantly improved at 6 and 12 months after LNG-IUS insertion compared to baseline scores. Mood and pain sub-scores showed the significant change, while the changes of the other sub-scores were non-significant.
Conclusion: LNG-IUS is a safe, effective and feasible therapeutic modality for menorrhagia and is associated with significant improvement of quality of life with special regard to mood and associated pelvic pain and could be recommended as first line of management for women in childbearing period wishing to retain their power to conceive in future.
|
