title: Are women satisfied when using levonorgestrel-releasing intrauterine system for treatment of abnormal uterine bleeding?
abstract: OBJECTIVE
  To determine the efficacy of levonorgestrel intrauterine system (LNG IUS) in treatment of abnormal uterine bleeding (AUB) in women over 35 years and to determine satisfaction of users of LNG IUS in case of AUB.
  
  
  METHODS
  This was a multicentric, retrospective, and observational study. Case records of patients with AUB from the hospitals in Pune, Delhi, and Gurgaon for the last 6 years were examined. Records of 80 women who had an LNG IUS inserted were included. The chief complaints and their duration were recorded. Investigation results, histopathology reports, and date of LNG IUS insertion were noted. The incidence of spotting, heavy menstrual bleeding, pain, expulsion, and amenorrhea were recorded at 3, 6, 12, and 18 months following treatment. Following this a telephonic interview was conducted to determine the efficacy of LNG IUS in treating the symptoms. Patients' satisfaction in percentage was also noted and they were asked if they would recommend the LNG IUS to other women.
  
  
  RESULTS
  The mean age of women was 42.3 years. 77.5% of the women had menorrhagia as the chief complaint, and the mean duration was 12 months. Fibroids and adenomyosis were the most common pathology, present in 21.3% and 20% of the patients respectively. At 3 months, spotting seemed to be the predominant symptom (59.4%) and only 15% women had heavy bleeding. 49.3% of women were asymptomatic at 6 months. 27.5% had amenorrhea by the end of 18 months. 14 women in whom the device was expelled or removed due to persistent symptoms, underwent hysterectomy at various stages during the study period. Overall patient satisfaction was high at about 80%. Furthermore, 73.8% patients agreed to recommend it to other women.
  
  
  CONCLUSIONS
  LNG IUS seems to be a viable and effective treatment option for AUB in women after 35 years. There is a high rate of patient satisfaction in appropriately selected patients.
authors.affiliation: Department of Obstetrics and Gynecology, Jehangir Hospital, Pune, Maharashtra, India.
authors.forename: Nina
authors.initials: N
authors.lastname: Mansukhani
authors.forename: Jyothi
authors.initials: J
authors.lastname: Unni
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Dua
authors.forename: Reeta
authors.initials: R
authors.lastname: Darbari
authors.forename: Sonia
authors.initials: S
authors.lastname: Malik
authors.forename: Sohani
authors.initials: S
authors.lastname: Verma
authors.forename: Sonal
authors.initials: S
authors.lastname: Bathla
keywords: Menorrhagia; non-surgical options; peri-menopausal women