The effect of levonorgestrel intrauterine system on uterine myomas: a 1-year follow-up study.
OBJECTIVE
To assess whether levonorgestrel intrauterine system is an effective means of therapy in menorrhagia associated with myomas.


METHODS
Prospective before and after study (Canadian Task Force classification II-1).


METHODS
Teaching and research hospital, a tertiary center.


METHODS
In all, 21 premenopausal women attending our gynecology clinic because of menorrhagia associated with uterine myomas were enrolled into the study.


METHODS
Levonorgestrel-releasing intrauterine system use in uterine myomas.


RESULTS
Patients with myomas greater than 4 cm were excluded. Clinical assessment tools of menstrual bleeding were measured both before (pretreatment) and 1 year after the insertion (posttreatment). A p value less than or equal to .05 was considered statistically significant for menstrual blood loss as a primary outcome and Bonferroni correction was done for secondary outcomes as 0.01. The mean age of the patients was 47.05+/-4.9 years. At 1-year follow-up, 5 women had had a hysterectomy. Four patients were amenorrheic. The duration of menstruation and the mean endometrial thickness were decreased 1 year after insertion; these decreases were not statistically significant (p=.034 and p=.204, respectively). While the mean number of pads used daily during menstruation decreased (p=.011), the hemoglobin level was increased (p=.001). A reduction in mean uterine volume and increase in ferritin levels were observed, but these changes did not reach statistical significance (p = .050 and p = .036, respectively).


CONCLUSIONS
The use of the levonorgestrel intrauterine system seems to be effective in reducing menorrhagia associated with myomas with improvement in hemoglobin levels.
Gunes
Muzeyyen
M
Turkiye Cumhuriyeti Saglik Bakanligi (Health Ministry, Republic of Turkey) Ankara Etlik Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.
Ozdegirmenci
Ozlem
O
Kayikcioglu
Fulya
F
Haberal
Ali
A
Kaplan
Metin
M
D000328:Adult; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D004717:Endometrium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D016912:Levonorgestrel / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D017697:Premenopause; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000150:complications / Q000188:drug therapy*
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel