Depressive symptoms as predictors of discontinuation of treatment of menorrhagia by levonorgestrel-releasing intrauterine system.
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.
Elovainio
Marko
M
National Research and Development Centre for Welfare and Health , P.O Box 220, Fin 00531, Helsinki, Finland. marko.elovainio@stakes.fi
Teperi
Juha
J
Aalto
Anna-Mari
AM
Grenman
Seija
S
Kivelä
Aarre
A
Kujansuu
Erkki
E
Vuorma
Sirkku
S
Yliskoski
Merja
M
Paavonen
Jorma
J
Hurskainen
Ritva
R
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*
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel