The levonorgestrel intrauterine system as an alternative to hysterectomy for the treatment of idiopathic menorrhagia

• Published in: Gynecological endocrinology 2009-01, Vol.25 (9), p.581-586
• Main Authors: Goñi, Álvaro Zapico, Lacruz, Ramón Lanzón, Paricio, Juan José Parilla, Hernández Rivas, Francisco J.
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Hysterectomy; Intrauterine Devices, Medicated - adverse effects; intrauterine system; Levonorgestrel; Levonorgestrel - therapeutic use; menorrhagia; Menorrhagia - therapy; menstrual bleeding; Menstrual Cycle; Middle Aged; Patient Satisfaction; Patient Selection; Prospective Studies; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0951-3590; 1473-0766
• DOI: 10.1080/09513590902972034

Aim of the study. Prospective, observational study to determine the percentage of hysterectomies cancelled after a year of treatment with levonorgestrel intrauterine system (LNG-IUS) among women diagnosed with idiopathic menorrhagia. Main findings. Eighty-two women with a mean age of 44.3 ± 4.9 were enrolled. Throughout 1-year follow-up, progressive and significant reduction was observed in number of days of bleeding (8.9 ± 4.0 vs. 5.0 ± 5.4), number of sanitary measures (29.3 ± 19.4 vs. 8.1 ± 10.8) and percentage of patients having intense very intense bleeding (98.8%vs. 6.4%). Duration of menstrual cycle significantly increased from 26.9 ± 5.5 to 52.6 ± 33.6 days. Significant improvement in overall health-related quality of life was achieved. Patient satisfaction was good very good in 70.7%. Considering only women who attended 12-month visit satisfaction reached 91.2%. 75.6% of scheduled hysterectomies were cancelled. Adverse effects were recorded in less than 40% of patients with no significant differences between visits. Adverse effects led to premature discontinuation of treatment in seven cases. No serious adverse effects were encountered. Interpretation of results. LNG-IUS meets the effectiveness and tolerability criteria for being considered as a first choice treatment option for women with idiopathic menorrhagia. Its use may contribute to decrease the large number of hysterectomies scheduled in Spain.