title: The levonorgestrel intrauterine system is an effective treatment in selected obese women with abnormal uterine bleeding.
abstract: OBJECTIVE
  To evaluate the use of the levonorgestrel intrauterine system (LNG-IUS) in obese premenopausal women with abnormal uterine bleeding (AUB).
  
  
  METHODS
  Prospective observational study (Canadian Task Force Classification II-2).
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  Fifty-six obese women with body mass index (BMI) >30 kg/m(2).
  
  
  METHODS
  From January 2002 through September 2009, 56 obese patients (BMI >30 kg/m(2)) with abnormal uterine bleeding (AUB) were identified from the senior author's clinical practice (G.A.V.). After clinical assessment, including Papanicolaou smear, endometrial biopsy, and pelvic sonography, the LNG-IUS was placed to treat their AUB.
  
  
  RESULTS
  The median and (range) for age, parity, and BMI were 42.5 years (20-64), 2 children (0-6), and 41.2 kg/m(2) (30-61), respectively. Many patients had additional comorbid conditions placing them at high risk for traditional medical or surgical therapies. The initial endometrial biopsy result was normal in 46 women (82.1%). Three women (5.4%) had inadequate sample, three (5.4%) had simple endometrial hyperplasia, two (3.6%) had complex endometrial hyperplasia without atypia, and two women (3.6%) had complex endometrial hyperplasia with atypia. After placement of the LNG-IUS, all women reported menstrual blood reduction at 3 and 6 months. The LNG-IUS was expelled in 2/56 patients (3.6%) and removed in 12 (21.4%), and a new device was inserted in 3/56 patients (5.4%). At median follow-up of 48 months (range 3-72), the satisfaction rate was 75%.
  
  
  CONCLUSIONS
  In properly selected obese women with AUB, the LNG-IUS is an effective therapy in approximately 75% of cases.
authors.affiliation: St. Joseph's Health Care, Department of Obstetrics and Gynecology, The University of Western Ontario, London, Ontaio, Canada. george.vilos@sjhc.london.on.ca
authors.forename: George A
authors.initials: GA
authors.lastname: Vilos
authors.forename: Jennifer
authors.initials: J
authors.lastname: Marks
authors.forename: Valentin
authors.initials: V
authors.lastname: Tureanu
authors.forename: Basim
authors.initials: B
authors.lastname: Abu-Rafea
authors.forename: Angelos G
authors.initials: AG
authors.lastname: Vilos
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D009765:Obesity; D017697:Premenopause; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel