Synergistic effect on the treatment of menorrhagia by endometrial biopsy followed by contemporaneous insertion of the levonorgestrel intrauterine system.
OBJECTIVE
To evaluate the efficacy of endometrial biopsy followed by intrauterine system-releasing levonorgestrel (LNG-IUS) insertion in the treatment of women with menorrhagia.


METHODS
This was a retrospective, non-comparative study. Ninety-two patients who had menorrhagia due to non-malignant causes were sequentially recruited into the study over a 3-year period (age range 29-51 years). Patients with a uterine size more than 12 weeks were not included. A LNG-releasing intrauterine system was inserted during the mid-cycle immediately after an endometrial biopsy was taken. One year after the closure of the study period, the women recruited were then contacted by telephone or by direct questioning at the outpatient clinic as to the outcome of the above treatment.


RESULTS
The most common (15%) complaint regarding bleeding patterns at 3-6 months after insertion was spotting and intermenstrual bleeding. Following the introduction of the LNG-IUS, six women required a hysterectomy for various reasons. The remaining 86 women (93.5%) continued the use of LNG-IUS.


CONCLUSIONS
LNG-IUS following an endometrial biopsy is an effective treatment for menorrhagia due to benign causes and could be an alternative to other forms of medical and surgical treatments.
Department of Obstetrics and Gynaecology, Mater Dei Hospital, Msida, Malta. yambaron@go.net.mt
Yves Muscat
YM
Baron
Johann
J
Craus
Rodianne Camilleri
RC
Agius
Mark
M
Brincat
D000328:Adult; D001706:Biopsy; D003131:Combined Modality Therapy; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D016912:Levonorgestrel