The effect of levonorgestrel intrauterine system on uterine myomas: a 1-year follow-up study.

Abstract

STUDY OBJECTIVE:

To assess whether levonorgestrel intrauterine system is an effective means of therapy in menorrhagia associated with myomas.

DESIGN:

Prospective before and after study (Canadian Task Force classification II-1).

SETTING:

Teaching and research hospital, a tertiary center.

PATIENTS:

In all, 21 premenopausal women attending our gynecology clinic because of menorrhagia associated with uterine myomas were enrolled into the study.

INTERVENTIONS:

Levonorgestrel-releasing intrauterine system use in uterine myomas.

MEASUREMENTS AND MAIN RESULTS:

Patients with myomas greater than 4 cm were excluded. Clinical assessment tools of menstrual bleeding were measured both before (pretreatment) and 1 year after the insertion (posttreatment). A p value less than or equal to .05 was considered statistically significant for menstrual blood loss as a primary outcome and Bonferroni correction was done for secondary outcomes as 0.01. The mean age of the patients was 47.05+/-4.9 years. At 1-year follow-up, 5 women had had a hysterectomy. Four patients were amenorrheic. The duration of menstruation and the mean endometrial thickness were decreased 1 year after insertion; these decreases were not statistically significant (p=.034 and p=.204, respectively). While the mean number of pads used daily during menstruation decreased (p=.011), the hemoglobin level was increased (p=.001). A reduction in mean uterine volume and increase in ferritin levels were observed, but these changes did not reach statistical significance (p = .050 and p = .036, respectively).

CONCLUSION:

The use of the levonorgestrel intrauterine system seems to be effective in reducing menorrhagia associated with myomas with improvement in hemoglobin levels.

• Authors: Muzeyyen Gunes, Ozlem Ozdegirmenci, Fulya Kayikcioglu, Ali Haberal, Metin Kaplan
• Journal: Journal of minimally invasive gynecology (J Minim Invasive Gynecol) 2008 Nov-Dec Vol. 15 Issue 6 Pg. 735-8 ISSN: 1553-4650 [Print] United States
• PMID: 18971138 (Publication Type: Journal Article)

Chemical References

• Contraceptive Agents, Female
• Levonorgestrel

Topics

• Adult
• Contraceptive Agents, Female (therapeutic use)
• Endometrium (pathology)
• Female
• Follow-Up Studies
• Humans
• Hysterectomy
• Leiomyoma (complications, drug therapy, surgery)
• Levonorgestrel (therapeutic use)
• Menorrhagia (drug therapy, etiology, surgery)
• Middle Aged
• Premenopause
• Prospective Studies
• Uterine Neoplasms (complications, drug therapy)