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Depressive symptoms as predictors of discontinuation of treatment of menorrhagia by levonorgestrel-releasing intrauterine system.

Abstract
It has been shown that levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective treatment of menorrhagia. However, the discontinuation rate of LNG-IUS treatment is high, and little is known about the actual reasons intertwining it. We tested the hypothesis that depressive symptoms is the factor responsible for deciding to have a hysterectomy during LNG-IUS treatment. The participants (119 women, ages = 35-49 years) were randomly selected over a 3-year period (1994-1997) to receive the LNG-IUS or a hysterectomy for the treatment of menorrhagia. Depressive symptoms, based on Beck's Depression Inventory measured 6 months after the beginning of the treatment, were related to discontinuation of LNG-IUS use Odds Ratio (OR) = 3.70, 95% Confidence Intervals (CI) 1.55-8.82, p = .003 during a 5-year follow-up. This association was not attenuated after adjustment for other known risk factors. Our findings suggest that diagnosing and treating depression among patients having menstrual problems may improve the continuity of LNG-IUS treatment of menorrhagia.
AuthorsMarko Elovainio, Juha Teperi, Anna-Mari Aalto, Seija Grenman, Aarre Kivelä, Erkki Kujansuu, Sirkku Vuorma, Merja Yliskoski, Jorma Paavonen, Ritva Hurskainen
JournalInternational journal of behavioral medicine (Int J Behav Med) Vol. 14 Issue 2 Pg. 70-5 ( 2007) ISSN: 1070-5503 [Print] United States
PMID17926434 (Publication Type: Journal Article)
Chemical References
  • Contraceptive Agents, Female
  • Levonorgestrel
Topics
  • Adult
  • Contraceptive Agents, Female
  • Depression (diagnosis, epidemiology, psychology)
  • Female
  • Humans
  • Hysterectomy (statistics & numerical data)
  • Intrauterine Devices, Medicated
  • Levonorgestrel (metabolism)
  • Medical Futility
  • Menorrhagia (drug therapy, epidemiology)
  • Prospective Studies
  • Uterus (metabolism, secretion)

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