{"paper_id":"23faba38-faed-4d5c-86d9-680be32cfbf7","body_text":"Abstract\nBackground\nLevonorgestrel Intra Uterine System insertion for contraception is preferred in the follicular phase. However, the ideal time of insertion for Abnormal Uterine Bleeding is not stated clearly. The aim of our study is to find out the effect of timing of insertion on expulsion and irregular bleeding pattern post insertion.\nMethods\nA follow-up study of patients with LNG-IUS for AUB was conducted. They were grouped into four based on the day of insertion from Last Menstrual Period (LMP). The pattern of irregular bleeding post insertion was compared with odds ratio and the expulsion rate was compared with log rank test.\nResults\nThe most common indication for the 76 patients was ovulatory dysfunction (39.4%) followed by Adenomyosis (36.84%). Those who had LNG-IUS insertion from day 22–30 had quicker expulsions of 25% of patients by 3 months. By 6 months and later expulsion rate was much higher in the luteal phase than the follicular phase (p < 0.03). The least risk of moderate or heavy bleeding was for the 8–15 day group when compared to the 22–30 day group, the odds ratio being 0.03 [95% CI: (0.01–0.2)].\nConclusion\nBased on expulsion rate alone, insertion of LNG-IUS at any time in the follicular phase is ideal. Considering both expulsion rate and pattern of bleeding the ideal time would be late follicular phase, that is 8–15th day.\nSimilar content being viewed by others\nReferences\nWhitaker L, Critchley HO. Abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2016;34:54–65. https://doi.org/10.1016/j.bpobgyn.2015.11.012.\nNational Institute for Health and Care Excellence. Heavy Menstrual Bleeding: Assessment and Management. National Institute for Health and Care Excellence, 2018 Contract No.: NICE Guideline No. 88.\nRoyal College of Obstetricians & Gynaecologists. Management of Endometrial Hyperplasia. 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Contraception. 2019;99(6):340–4. https://doi.org/10.1016/j.contraception.2019.02.004.\nFunding\nThis research didnot recieve any funding from public, commercial or not-for-profit sectors.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that there is no conflict of interest associated with this manuscript.\nEthical Approval\nEthical approval was obtained from the Institutional Ethics Committee of Believers Church Medical College, Thiruvalla, Kerala.\nEthical Standard\nThe study was conducted in accordance with the ethical standards of our Institutional Ethics and Research Committee and with 1964 declaration of Helsinki and its amendments.\nInformed Consent\nInformed consent was taken from all participants at the beginning of study.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nDr. Sunitha Mary Mathew MS(OBG), DGO, DNB(OBG), is an Associate Professor, Department of Obstetrics and Gynecology, Believers Church Medical College Hospital, Thiruvalla, India; Dr. Alice David MSc., PhD (USA) is a Head of Medical Research (Epidemiology & Biostatistics), Believers Church Medical College Hospital, Thiruvalla, India.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nMathew, S.M., David, A. Does Timing of Levonorgestrel Insertion in Women with Abnormal Uterine Bleeding Affect its Expulsion and Bleeding Pattern? A Follow-Up Study. J Obstet Gynecol India 73, 160–165 (2023). https://doi.org/10.1007/s13224-022-01714-y\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s13224-022-01714-y","source_license":"CC0","license_restricted":false}