title: Depressive symptoms as predictors of discontinuation of treatment of menorrhagia by levonorgestrel-releasing intrauterine system.
abstract: It has been shown that levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective treatment of menorrhagia. However, the discontinuation rate of LNG-IUS treatment is high, and little is known about the actual reasons intertwining it. We tested the hypothesis that depressive symptoms is the factor responsible for deciding to have a hysterectomy during LNG-IUS treatment. The participants (119 women, ages = 35-49 years) were randomly selected over a 3-year period (1994-1997) to receive the LNG-IUS or a hysterectomy for the treatment of menorrhagia. Depressive symptoms, based on Beck's Depression Inventory measured 6 months after the beginning of the treatment, were related to discontinuation of LNG-IUS use Odds Ratio (OR) = 3.70, 95% Confidence Intervals (CI) 1.55-8.82, p = .003 during a 5-year follow-up. This association was not attenuated after adjustment for other known risk factors. Our findings suggest that diagnosing and treating depression among patients having menstrual problems may improve the continuity of LNG-IUS treatment of menorrhagia.
authors.affiliation: National Research and Development Centre for Welfare and Health , P.O Box 220, Fin 00531, Helsinki, Finland. marko.elovainio@stakes.fi
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.forename: Juha
authors.initials: J
authors.lastname: Teperi
authors.forename: Anna-Mari
authors.initials: AM
authors.lastname: Aalto
authors.forename: Seija
authors.initials: S
authors.lastname: Grenman
authors.forename: Aarre
authors.initials: A
authors.lastname: Kivelä
authors.forename: Erkki
authors.initials: E
authors.lastname: Kujansuu
authors.forename: Sirkku
authors.initials: S
authors.lastname: Vuorma
authors.forename: Merja
authors.initials: M
authors.lastname: Yliskoski
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.forename: Ritva
authors.initials: R
authors.lastname: Hurskainen
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000378:metabolism*; D018447:Medical Futility; D008595:Menorrhagia / Q000188:drug therapy* / Q000453:epidemiology*; D011446:Prospective Studies; D014599:Uterus / Q000378:metabolism*
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel