The efficacy of the levonorgestrel-releasing intrauterine system in perimenopausal women with menorrhagia or dysmenorrhea

In: Archives of Gynecology and Obstetrics · 2011 · vol. 285(1) , pp. 161–166 · doi:10.1007/s00404-011-1937-3 · PMID:21671063 · W1996155499
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AI-generated summary by gemini-2.5-flash-lite, 2026-07-19

This study analyzed 192 perimenopausal women and found that persistent pain after 3 months and heavy bleeding after 6 months were factors predicting hysterectomy, with 80.7% successfully using the LNG-IUS for 2 years.

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This retrospective study evaluated the efficacy of the levonorgestrel-releasing intrauterine system in 192 perimenopausal women suffering from menorrhagia or dysmenorrhea over a two-year period. The results indicated an overall success rate of 80.7%, with hysterectomy rates significantly influenced by persistent pain scores at three months and bleeding amounts at six months, rather than baseline demographic or clinical factors. The authors concluded that while the device is generally effective, early failure indicators can predict the need for surgical intervention. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

ObjectiveTo evaluate the hysterectomy rates and the risk factors for hysterectomy during the first 2 years of use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in perimenopausal women who had complaints of either menorrhagia or dysmenorrhea.MethodsOne hundred ninety-two women over 40 years old were retrospectively analyzed for a 2-year follow-up period. The changes in the amount and duration of bleeding and the pain scores were checked at 3, 6, 12 and 24 months.ResultsTwenty-six (13.5%) women failed with LNG-IUS treatment and they received hysterectomy. Age, parity, the type of diseases, the amount of menstrual bleeding, the mean duration of persisted menorrhagia and the severity of pain before treatment were not the factors affecting removal of the LNG-IUS and undergoing hysterectomy. However, the pain score of the third month and the amount of bleeding on the sixth month were the factors affecting undergoing hysterectomy (P < 0.05). When hysterectomy was performed, the average duration from LNG-IUS insertion to hysterectomy was 8.9 months. The participants who persisted with the LNG-IUS treatment for 24 months showed a success rate of 80.7%.ConclusionLNG-IUS is an effective device for the treatment of perimenopausal women who have complaints of either menorrhagia or dysmenorrhea. Insufficient reduction of pain score during the first 3 months and menstrual blood loss during the first 6 months after insertion of the LNG-IUS were important factors that affected undergoing hysterectomy.
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Abstract

Objective To evaluate the hysterectomy rates and the risk factors for hysterectomy during the first 2 years of use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in perimenopausal women who had complaints of either menorrhagia or dysmenorrhea.

Methods

One hundred ninety-two women over 40 years old were retrospectively analyzed for a 2-year follow-up period. The changes in the amount and duration of bleeding and the pain scores were checked at 3, 6, 12 and 24 months.

Results

Twenty-six (13.5%) women failed with LNG-IUS treatment and they received hysterectomy. Age, parity, the type of diseases, the amount of menstrual bleeding, the mean duration of persisted menorrhagia and the severity of pain before treatment were not the factors affecting removal of the LNG-IUS and undergoing hysterectomy. However, the pain score of the third month and the amount of bleeding on the sixth month were the factors affecting undergoing hysterectomy (P < 0.05). When hysterectomy was performed, the average duration from LNG-IUS insertion to hysterectomy was 8.9 months. The participants who persisted with the LNG-IUS treatment for 24 months showed a success rate of 80.7%.

Conclusion

LNG-IUS is an effective device for the treatment of perimenopausal women who have complaints of either menorrhagia or dysmenorrhea. Insufficient reduction of pain score during the first 3 months and menstrual blood loss during the first 6 months after insertion of the LNG-IUS were important factors that affected undergoing hysterectomy. Similar content being viewed by others

References

Lidor A, Ismajovich B, Confino E, David MP (1986) Histopathological findings in 226 women with postmenopausal uterine bleeding. Acta Obstet Gynaecol Scand 65:41–43 Backman T, Huhtala S, Luoto R, Tuominen J, Rauramo I, Kosekenvuo M (2002) Advance information improves users satisfaction with the levonorgestrel intrauterine system. Obstet Gynecol 99:608–613 Burger HG, Dudley EC, Robertson DM, Dennerstein L (2002) Hormonal changes in the menopause transition. Recent Prog Horm Res 57:257–275 Varma R, Sinha D, Gupta JK (2006) Non-contraceptive uses of levonorgestrel releasing hormone system (LNG-IUS): a systematic enquiry and overview. Eur J Obstet Gynecol Reprod Biol 125:9–28 Jensen JT (2005) Contraceptive and therapeutic effects of levonorgestrel intrauterine system: an overview. Obstet Gynecol Surv 60:604–612 Nagrani R, Bowen-Simpkins P, Barrington JW (2002) Can the levonorgestrel intrauterine system replace surgical treatment for the management of menorrhagia? Br J Obstet Gynaecol 109:345–347 Higham JM, O’Brien PM, Shaw RW (1990) Assessment of menstrual blood loss using a pictorial chart. Br J Obstet Gynaecol 97:734–739 Biberoglu KO, Behrman SJ (1981) Dosage aspects of danazol therapy in endometriosis: short-term and long-term effectiveness. Am J Obstet Gynecol 139:645–650 Bazot M, Cortez A, Darai E (2001) Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod 16:2427–2433 Fedele L, Bianchi S, Dorta M, Arcaini L, Zanotti F, Carinelli S (1992) Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis. Fertil Steril 58:94–97 Reinhold C, Atri M, Mehio A, Zakarian R, Aldis AE, Bret PM (1995) Diffuse uterine adenomyosis: morphologic criteria and diagnostic accuracy of endovaginal sonography. Radiology 197:609–614 Stewart A, Cummins C, Gold L, Jordan R, Phillips W (2001) The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review. BJOG 108:74–86 Phillips V, Graham CT, Manek S, McCluggage WG (2003) The effects of levonorgestrel intrauterine system (Mirena coil) on endometrial morphology. J Clin Pathol 56:305–307 Kucuk T, Ertan K (2008) Continuous oral or intramuscular medroxyprogesterone acetate versus the levonorgestrel releasing intrauterine system in the treatment of perimenopausal menorrhagia: a randomized, prospective, controlled clinical trial in female smokers. Clin Exp Obstet Gynecol 35:57–60 Lahteenmaki P, Haukkamaa M, Puolakka J (1998) Open randomized study of use of levonorgestrel-releasing intrauterine system as alternative to hysterectomy. BMJ 316:1122–1126 Monteiro I, Bahamondes L, Diaz J, Perrotti M, Petta C (2002) Therapeutic use of Levonorgestrel releasing intrauterine system in women with menorrhagia: a pilot study. Contraception 65:325–328 Stewart A, Cummins C, Gold L, Jordan R, Phillips W (2001) The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review. Br J Obstet Gynaecol 108:74–86 Rutanen EM, Salmi A, Nyman T (1997) mRNA expression of insulin-like growth factor-I (IGF-I) is suppressed and those of IGF-II and IGF-binding protein-1 are constantly expressed in the endometrium during use of an intrauterine levonorgestrel system. Mol Hum Reprod 3:749–754 Pekonen F, Nyman T, Lahteenmaki P, Haukkamaa M, Rutanen EM (1992) Intrauterine progestin induces continuous insulin-like growth factor–binding protein-1 production in the human endometrium. J Clin Endocrinol Metab 75:660–664 Maruo T, Matsuo H, Samoto T, Shimomura Y, Kurachi O, Gao Z et al (2000) Effects of progesterone on uterine leiomyoma growth and apoptosis. Steroids 65:585–592 Jarvela I, Tekay A, Jouppila P (1998) The effect of a levonorgestrel-releasing intrauterine system on uterine artery blood flow, hormone concentrations and ovarian cyst formation in fertile women. Hum Reprod 13:3379–3383 Smith SK (1998) The pathophysiology of menstruation. In: Cameron IT, Fraser IS, Smith SK (eds) Clinical disorders of the endometrium and the menstrual cycle. Oxford University Press, Oxford, pp 105–115 Conflict of interest The authors have no financial disclosures to declare and no conflicts of interest to report. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Yoo, H.J., Lee, M.A., Ko, Y.B. et al. The efficacy of the levonorgestrel-releasing intrauterine system in perimenopausal women with menorrhagia or dysmenorrhea. Arch Gynecol Obstet 285, 161–166 (2012). https://doi.org/10.1007/s00404-011-1937-3 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-011-1937-3

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