Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device

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This study investigated the effectiveness of a levonorgestrel-releasing intrauterine device in treating menorrhagia associated with adenomyosis.

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Abstract

ObjectiveTo evaluate the efficacy and tolerability of treatment with a levonorgestrel-releasing intrauterine device (IUD) in women affected by adenomyosis-associated menorrhagia.SettingTertiary care center.DesignProspective, open, noncomparative study.Patient(s)Twenty-five women aged 38 to 45 years with recurrent menorrhagia associated with adenomyosis diagnosed at transvaginal ultrasonography participated in this study.Intervention(s)An IUD releasing levonorgestel 20 mcg/day was inserted in each patient within 7 days of the start of menstrual flow. All of the patients were requested to compile a pictorial blood loss assessment chart each month. They underwent clinical and transvaginal ultrasound examinations 3, 6, and 12 months after IUD insertion.Main outcome measure(s)Menstrual pattern; serum hemoglobin, ferritin, and iron level changes.Result(s)One patient experienced IUD expulsion 2 months after device insertion and another requested removal of the IUD 4 months after insertion because of persistent irregular blood loss. Six months after IUD insertion, amenorrhea was observed in 2 patients and oligomenorrhea in another, spotting occurred occasionally in 7, and 13 had scanty but regular flow. One year of follow-up has been completed by the remaining 23 women: 2 with amenorrhea, 3 with oligomenorrhea, 2 with spotting, and 16 with regular flows. Significant increases in hemoglobin, hematocrit, and serum ferritin have been observed, but the lipid metabolism and clotting variables have remained unchanged.Conclusion(s)Our findings indicate that marked and safe relief from adenomyosis-associated menorrhagia can be obtained with the use of a levonorgestrel-releasing IUD.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Intrauterine Devices Intrauterine Devices Levonorgestrel Menorrhagia Adult Endometriosis Female Humans Levonorgestrel Menorrhagia Middle Aged Prospective Studies

Citation neighborhood

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europepmc
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License: CC0 · commercial use OK