LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM IN ADENOMYOSIS; PREDICTORS FOR RESPONSE AND CLINICAL OUTCOME

Fadia J Alizzi, Hind Abdul Khaliq Showman, Hayder Adnan Fawzi
In: Asian Journal of Pharmaceutical and Clinical Research · 2018 · vol. 11(12) , pp. 214 · doi:10.22159/ajpcr.2018.v11i12.27109 · W2904883429
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that the levonorgestrel-releasing intrauterine system effectively treats symptomatic adenomyosis, with initial menstrual blood loss, hemoglobin, and uterine volume predicting patient response.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective single-arm study enrolled women aged 39 years and older with symptomatic adenomyosis who had completed their families and treated them with a levonorgestrel-releasing intrauterine system (LNG-IUS) between August 2015 and March 2018, assessing symptom changes and ultrasonographic features over a mean follow-up of about 23 months. The LNG-IUS significantly improved menstrual blood loss, dysmenorrhea, and hemoglobin, alongside a significant reduction in uterine volume. Multivariate analysis found baseline menstrual blood loss and hemoglobin as good predictors of response, while initial uterine volume showed the strongest predictive performance, with the first 6 months identified as the best period to predict failure; the authors frame results within a single-arm design without a comparator. This paper is centrally about endometriosis or adenomyosis — it specifically evaluates predictors of response and clinical outcomes to an LNG-IUS in adenomyosis.

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Abstract

Objectives: The aim is to detect clinical and ultrasonographic characters that predict the response of adenomyosis to levonorgestrel-releasing intrauterine system (LNG-IUS) and to evaluate the clinical efficacy and the time needed to show a response.Methods: A prospective single-arm study conducted in the Obstetrics and Gynaecology Department Al-Yarmouk Teaching Hospital in Baghdad/Iraq from August 2015 to March 2018. Women with symptomatic adenomyosis with age 39 years and above and who completed their families had been enrolled in this study. LNG-IUS was used as a treatment; the outcome measure was to evaluate its effect in improving the symptoms and the time needed to show a clinical response. Multivariate analysis was used to assess the contribution of the clinical and ultrasonographic parameters to the prediction of the response to LNG-IUS.Results: Over the mean duration of follow-up period of the study (22.7±9.9 months), there was a significant improvement in menstrual blood loss, dysmenorrhea, and hemoglobin (Hb) with significant decrease in uterine volume (p˂0.001). The time to show response was as early as 3 months and the first 6 months is the best time to predict failure. Initial menstrual blood loss and Hb were good predictors to show response while uterine volume an excellent one (positive predictive value 80% and negative predictive value 97.2%).Conclusion: Levonorgestrel-releasing intrauterine device is an effective treatment of symptomatic adenomyosis in term of time to response and duration of response. The presenting Hb, menstrual blood loss, and uterine volume are useful predictors of response.

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adenomyosisdysmenorrhea

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