title: Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device.
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of treatment with a levonorgestrel-releasing intrauterine device (IUD) in women affected by adenomyosis-associated menorrhagia.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Prospective, open, noncomparative study.
  
  
  METHODS
  Twenty-five women aged 38 to 45 years with recurrent menorrhagia associated with adenomyosis diagnosed at transvaginal ultrasonography participated in this study.
  
  
  METHODS
  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.
  
  
  METHODS
  Menstrual pattern; serum hemoglobin, ferritin, and iron level changes.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Our findings indicate that marked and safe relief from adenomyosis-associated menorrhagia can be obtained with the use of a levonorgestrel-releasing IUD.
authors.affiliation: Department of Obstetrics and Gynecology, University of Verona, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fedele
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: R
authors.initials: R
authors.lastname: Raffaelli
authors.forename: A
authors.initials: A
authors.lastname: Portuese
authors.forename: M
authors.initials: M
authors.lastname: Dorta
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications*; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D016912:Levonorgestrel