Effectiveness and safety of Levonorgestrel Releasing IntrauterineSystem in treatment of menorrhagia secondary to oral anticoagulationsand chronic liver disease

Abeera Choudry, Ayesha Malik, Humaira Choudry, Naila Bangish, Naheed Hayat
In: Rawal Medical Journal · 2009 · vol. 34(2) , pp. 187–190 · W2114596972
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The levonorgestrel-releasing intrauterine system effectively reduced menstrual blood loss by up to 85% at one year in patients with bleeding disorders or on oral anticoagulants.

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Abstract

Objective To determine whether the levonorgesterol releasing intra-uterine contraceptive device can safely reduce menstrual blood loss and improve quality of life in patients with bleeding disorders and those on oral anticoagulation. Methods Patients presenting with menorrhagia, without pelvic pathology and suffering from bleeding disorder or using oral anticoagulants had Mirena inserted at Military Hospital, Rawalpindi. Baseline hemoglobin and menstrual blood loss was evaluated using pictorial blood assessment chart. Follow up hemoglobin and menstrual assessments were performed at 3, 6 and 12 months. At 12 months, patient satisfaction was assessed. Results Eighteen patients with bleeding disorders (3 chronic liver disease and 6 on anticoagulation with warfarin) were included in the study. One patient was lost to follow up after 3 months. Remaining were followed for one year. Continuity rate was 91% at one year. Mirena resulted in decrease in menstrual blood loss by 60% at 3 months, 70% at 6 months and 85 % at one year (p

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