Levonorgestrel intrauterine system: bleeding disorders and anticoagulant therapy.
Hemostatic disorders in women are frequently associated with long-standing menorrhagia. This leads to significant morbidity and adversely affects quality of life. Management of these women poses a particular challenge; medical treatments may be contraindicated, and surgery carries additional risks. The levonorgestrel intrauterine system (LNG-IUS) has been shown to be highly efficacy in reducing menstrual blood loss in women with normal coagulation. It is also a reliable and reversible contraceptive. Data on the use of this system in women with bleeding disorders or those receiving anticoagulant therapy are limited. Analysis of data from four reported studies suggests that LNG-IUS is a viable and safe option for the management of menorrhagia in these women. Whether the underlying hemostatic disorders lead to a shorter duration of action or prolonged irregular bleeding/spotting post insertion is unknown and requires large prospective studies. Proper counselling remains crucial for patients' satisfaction.
Kadir
Rezan A
RA
Department of Obstetrics and Gynaecology and Katharine Dormandy Haemophilia Center and Haemostasis Unit, Royal Free Hospital, NW3 2QG London, UK. rezan.abdul-kadir@royalfree.nhs.uk
Chi
Claudia
C
D000925:Anticoagulants / Q000627:therapeutic use; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications / Q000188:drug therapy; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004412:Dysmenorrhea / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000188:drug therapy* / Q000209:etiology
D000925:Anticoagulants; D003271:Contraceptive Agents, Female; D016912:Levonorgestrel