Levonorgestrel-releasing intrauterine device in the treatment of abnormal uterine bleeding: a 6- and 12-month morphological and clinical follow-up

Vittorio Palmara, Emanuele Sturlese, Daniela Villari, Valentina Giacobbe, Annalisa Retto, Giuseppe Santoro
In: Australian and New Zealand Journal of Obstetrics and Gynaecology · 2013 · vol. 53(4) , pp. 381–385 · doi:10.1111/ajo.12097 · PMID:23701372 · W2114420320
article OA: closed CC0 ⤵ 2 in-corpus citations
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This study evaluated a levonorgestrel intrauterine device in women with abnormal uterine bleeding, finding it reduced endometrial thickness and bleeding while improving quality of life at 6 and 12 months.

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Abstract

BACKGROUND: Abnormal uterine bleeding is defined as any alteration in the pattern or volume of menstrual blood flow, and it is preferably treated using hysterectomy, endometrial destruction or the levonorgestrel-releasing intrauterine system (Mirena(®) ). Recently, it has been demonstrated that studies of Mirena(®) were generally small and consequently imprecise. AIMS: Our study was aimed at assessing the effects of a slow-release levonorgestrel (20 μg/day) intrauterine device in fertile and postmenopausal women experiencing abnormal uterine bleeding that did not respond to traditional medical management. MATERIALS AND METHODS: A total of 40 women, of whom 24 were of reproductive capacity and 16 were postmenopausal, were enrolled in the trial. Removal of the intrauterine device was required for only 2 of the 24 fertile women and for only 3 of the 16 postmenopausal women. After 6 and 12 months of treatment, the remaining women were clinically evaluated and underwent ultrasound and hysteroscopy using biopsy specimens as a control. The EuroQol Group EQ-5D questionnaire was used for evaluation of quality of life. RESULTS: The device showed good tolerability and efficacy. It resulted in a reduction in the endometrial mucosal thickness with a regression of bleeding and collateral effects, which were more evident after 12 months of treatment. A positive effect of the device on the woman's quality of life was demonstrated. CONCLUSIONS: The slow-release levonorgestrel intrauterine device may be a valid therapeutic tool for treating basic symptomatology and increasing quality of life in women with abnormal uterine bleeding.

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