Combined administration of Dienogest and Levonorgestrel – Releasing Intrauterine System Mirena

Objectives: Intrauterine hormone-releasing systems are now widely applied to treat metrorrhagia (polymenorrhea), endometrial hyperplasia and adenomyosis. In previous works we found that risk factors for expulsion of intrauterine device, besides the deformation of the uterine cavity, was the expansion of uterine cavity area > 9 cm2, associated with increased distance between tubal angles >4.5 cm and after the insertion of Levonorgestrel-releasing Intrauterine System (Mirena), among the patients with indicated parameters of uterine cavity, the expulsion reached 90%. Another widely used medicine for treatment of metrorrhagia (polymenorrhea), endometrial hyperplasia and adenomyosis is dienogest (Vizanna). The objective of this study is to explore the influence of combined administration of dienogest and Levonorgestrel- releasing Intrauterine System with the purpose of prevention of complications and side effects of the Intrauterine System. Study design: This prospective study includes 32 patients with previous Levonorgestrel-releasing Intrauterine System expultions whom Dienogest 2mg daily has been administered within 6 months. Results: Ultrasound transformation of a myometrium and uterine cavity in 6 months after Vizanna administration was manifested by minimization of uterine cavity and reduction of distance between tubal angles. Mirena was inserted to these patients again. Within 12 months of monitoring any case of expulsion was not observed. Conclusions: According to the data received, the combined consistent and simultaneous administration of Dienogest and Mirena reduces the possibility of Intrauterine System expulsion and decreases side effects of the Intrauterine System. Implication statement: Combined consistent and simultaneous administration of Dienogest and Levonorgestrel-releasing Intrauterine System was used for prevention of complications of Intrauterine System