Therapeutic effects of the levonorgestrel-releasing intrauterine system in the treatment of idiopathic menorrhagia.
OBJECTIVE
To investigate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of idiopathic menorrhagia.


METHODS
Measurements of menstrual blood loss (MBL), hemoglobin, and serum ferritin before and after LNG-IUS insertion.


METHODS
National Research Institute for Family Planning and Beijing Gynecology and Obstetrics Hospital, Beijing, People's Republic of China.


METHODS
Thirty-four patients with MBL over 80 mL.


METHODS
Insertion of the LNG-IUS on cycle days 5-7 and follow-up at 3-month intervals for 3 years.


METHODS
Measurement of MBL, serum ferritin, and hemoglobin for evaluation of efficacy of treatment.


RESULTS
A significant reduction of MBL to 23.4 mL (78.7% decrease), 26.4 mL (83.8% decrease), 2.7 mL (97.7% decrease), and 13.7 mL (85.0% decrease) at 6, 12, 24, and 36 months, respectively. After 6 months, one-third of the patients experienced amenorrhea, and one-fourth, spotting. Hemoglobin increased significantly from 121.5 g/L preinsertion to 135.5 g/L after 36 months, while serum ferritin levels increased significantly from 21.9 ng/mL before insertion to 92.8 ng/mL after 36 months. In women using the LNG-IUS for 3-4 years, the E2 levels in 20 samples were 239.4 pmol/L, P levels were 11.1 nmol/L, and serum LNG levels were maintained at an average of 511 pmol/L.


CONCLUSIONS
The significant reduction of MBL and the increase in hemoglobin and serum ferritin levels in the treatment of menorrhagia with the LNG-IUS has great implications for women's reproductive health, particularly in developing countries.
National Research Institute for Family Planning, and Beijing Gynecology and Obstetrics Hospital, Beijing, People's Republic of China. xiaobl@public.bta.net.cn
Bilian
B
Xiao
Shang-Chun
SC
Wu
Jie
J
Chong
Tao
T
Zeng
Li-Hui
LH
Han
Tapani
T
Luukkainen
D000328:Adult; D002681:China; D004958:Estradiol / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D008595:Menorrhagia / Q000097:blood / Q000188:drug therapy*; D008598:Menstruation / Q000097:blood / Q000187:drug effects; D011374:Progesterone / Q000097:blood; D045167:Progesterone Congeners / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
D006454:Hemoglobins; D045167:Progesterone Congeners; D011374:Progesterone; D004958:Estradiol; D016912:Levonorgestrel; D005293:Ferritins