title: The efficacy of the levonorgestrel-releasing intrauterine system in perimenopausal women with menorrhagia or dysmenorrhea.
abstract: OBJECTIVE
  To evaluate the hysterectomy rates and the risk factors for hysterectomy during the first 2 years of use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in perimenopausal women who had complaints of either menorrhagia or dysmenorrhea.
  
  
  METHODS
  One hundred ninety-two women over 40 years old were retrospectively analyzed for a 2-year follow-up period. The changes in the amount and duration of bleeding and the pain scores were checked at 3, 6, 12 and 24 months.
  
  
  RESULTS
  Twenty-six (13.5%) women failed with LNG-IUS treatment and they received hysterectomy. Age, parity, the type of diseases, the amount of menstrual bleeding, the mean duration of persisted menorrhagia and the severity of pain before treatment were not the factors affecting removal of the LNG-IUS and undergoing hysterectomy. However, the pain score of the third month and the amount of bleeding on the sixth month were the factors affecting undergoing hysterectomy (P < 0.05). When hysterectomy was performed, the average duration from LNG-IUS insertion to hysterectomy was 8.9 months. The participants who persisted with the LNG-IUS treatment for 24 months showed a success rate of 80.7%.
  
  
  CONCLUSIONS
  LNG-IUS is an effective device for the treatment of perimenopausal women who have complaints of either menorrhagia or dysmenorrhea. Insufficient reduction of pain score during the first 3 months and menstrual blood loss during the first 6 months after insertion of the LNG-IUS were important factors that affected undergoing hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea. bell4184@gmail.com
authors.forename: Heon Jong
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Min A
authors.initials: MA
authors.lastname: Lee
authors.forename: Young Bok
authors.initials: YB
authors.lastname: Ko
authors.forename: Jung Bo
authors.initials: JB
authors.lastname: Yang
authors.forename: Byung Hun
authors.initials: BH
authors.lastname: Kang
authors.forename: Ki Hwan
authors.initials: KH
authors.lastname: Lee
mesh_terms: D004412:Dysmenorrhea / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D047648:Perimenopause / Q000187:drug effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D016912:Levonorgestrel