title: Levonorgestrel-releasing intrauterine system for the management of heavy menstrual bleeding in women with inherited bleeding disorders: long-term follow-up.
abstract: BACKGROUND
  There are currently limited data on the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) for the management of heavy menstrual bleeding (HMB) in women with inherited bleeding disorders (IBDs) particularly on its long-term (>12 months) efficacy.
  
  
  METHODS
  This study involves a case series of women with IBDs who received the LNG-IUS as treatment for HMB. Menstrual blood loss before its insertion and at the time of follow-up was assessed by the pictorial blood-loss assessment chart (PBAC) and hemoglobin (Hb) concentrations. A questionnaire was used to evaluate quality of life (QOL) during menstruation before and after insertion of the LNG-IUS.
  
  
  RESULTS
  Twenty-six women were included. The median duration of LNG-IUS use at follow-up was 33 months (range, 14-103). The median PBAC score decreased from 255 (range, 134-683) to 35 (range, 0-89) with LNG-IUS use. The median Hb concentrations (11.2 to 13.2 g/dL) and QOL scores (median, 26 to 52) improved significantly with LNG-IUS use (p<.01).
  
  
  CONCLUSIONS
  The LNG-IUS appears to be an effective long-term treatment for HMB in women with IBDs.
authors.affiliation: Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK.
authors.forename: Claudia
authors.initials: C
authors.lastname: Chi
authors.forename: Farah Y
authors.initials: FY
authors.lastname: Huq
authors.forename: Rezan A
authors.initials: RA
authors.lastname: Kadir
mesh_terms: D000293:Adolescent; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006474:Hemorrhagic Disorders / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel