The Efficacy of Levonorgestrel Medicated Intrauterine Device in Relieving Symptoms of Adenomyosis

Background: The Mirena intrauterine device (IUD) is a successful treatment for adenomyosis, a benign estrogen-dependent condition that causes menorrhagia and dysmenorrhea. The purpose of this study was to evaluate the effectiveness of levonorgestrel-medicated intrauterine devices in relieving symptoms of adenomyosis. Methods: This randomized clinical trial included 36 patients suffering from dysmenorrhea and/or menorrhagia, selected from the outpatient clinic of the Obstetrics and Gynecology Department at Zagazig University Hospital. The patients were divided into two groups: Group A consisted of 18 patients who received continuous combined oral contraceptives (COCs) as treatment, while Group B included 18 patients who had a Mirena device inserted. Results: There were no statistically significant differences between the two groups regarding age or BMI (p>0.05). Similarly, no significant differences were observed in parity, number of living children, number of abortions, mode of delivery, duration since last pregnancy, dysmenorrhea, chronic pelvic pain, VAS score, or hemoglobin level (p>0.05). Both groups showed a reduction in HMB over time, with no statistically significant differences between COC and Mirena at any follow-up point. Regarding adverse effects, vaginal spotting, amenorrhea, breast tenderness, and hot flushes were reported in both groups without statistically significant differences (p>0.05). Conclusion: Both treatment modalities were associated with improvement in adenomyosis-related symptoms, Heavy menstrual bleeding, with superiority of Mirena regarding pain reduction and rise in hemoglobin levels