title: Use of the levonorgestrel-releasing intrauterine system in women with hemostatic disorders.
abstract: OBJECTIVE
  To evaluate the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) in women with known hemostatic disorders and abnormal uterine bleeding.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  Women with regular, heavy menstrual bleeding who have von Willebrand's disease and/or are receiving anticoagulation therapy for a thrombotic disorder.
  
  
  METHODS
  Levonorgestrel intrauterine system.
  
  
  METHODS
  Impact on menstrual bleeding and quality of life.
  
  
  RESULTS
  Seven women with hemostatic disorders who had used the LNG-IUS were identified. All 7 women completed the survey. Median age was 38 years (range 28-48 years). Six women were white, 1 woman was black. Four women had von Willebrand's disease. Four women were using anticoagulation, 3 warfarin, and 2 aspirin. One woman had both von Willebrand's disease and was heterozygous for factor V Leiden. All 7 women had heavy menstrual bleeding. After placement of the LNG-IUS, a decrease in number of bleeding days was seen in 71% of subjects (5 of 7), with overall median days reduced from 9 to 3 days. One subject discontinued use of the LNG-IUS because she desired pregnancy. Two subjects (29%) had no benefit from the LNG-IUS. Quality of life improved after placement of the LNG-IUS.
  
  
  CONCLUSIONS
  The LNG-IUS seems to be an effective treatment for heavy menses in women with hemostatic disorders. Providers should consider this option for women with hemostatic disorders because it is safe and simple to use.
authors.affiliation: Carolina Women's Research and Wellness Center, Chapel Hill, North Carolina 27514, USA. andrealukes@cwrwc.com
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Lukes
authors.forename: Beth
authors.initials: B
authors.lastname: Reardon
authors.forename: Gowthami
authors.initials: G
authors.lastname: Arepally
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D003692:Delayed-Action Preparations / Q000008:administration & dosage*; D005260:Female; D020141:Hemostatic Disorders / Q000188:drug therapy*; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000188:drug therapy*; D014842:von Willebrand Diseases / Q000188:drug therapy*
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D016912:Levonorgestrel