title: Oral anticoagulant therapy does not modify the bleeding pattern associated with the levonorgestrel-releasing intrauterine system in women with thrombophilia and/or a history of thrombosis.
abstract: BACKGROUND
  Progestogen-only contraceptives (POCs) are suitable for women with thrombophilia and/or a history of venous thromboembolism (VTE). Several of these women, however, use oral anticoagulant therapy (OAT), which can impair the bleeding pattern associated with POC use. We evaluated the effects of OAT use on the bleeding pattern associated with the levonorgestrel-releasing intrauterine system (LNG-IUS) in women with thrombophilia and/or a history of VTE.
  
  
  METHODS
  This prospective cohort study followed two groups of women, all of whom were thrombophilic and/or had a history of VTE: OAT users and nonusers. Bleeding patterns, blood pressure, body mass index (BMI), weight, complete blood count and waist circumference were compared between the two groups before and 6 and 12 months after LNG-IUS insertion.
  
  
  RESULTS
  The patient cohort consisted of 33 women aged 18 to 45 years old, including 16 OAT users and 17 nonusers. Body weight increased by 3.9% and BMI by 3.8% in OAT users 12 months after LNG-IUS insertion. Hemoglobin and hematocrit levels increased by approximately 10% in both groups. There was no difference between the groups in bleeding patterns, with amenorrhea being the most frequent pattern in both groups (41.2% each) 12 months after LNG-IUS insertion. OAT did not increase the frequency of prolonged and/or frequent bleeding.
  
  
  CONCLUSIONS
  OAT users and nonusers had similar bleeding patterns after insertion of the LNG-IUS. Hemoglobin and hematocrit levels increased in both groups.
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Ribeirao Preto, University of São Paulo, 3900-Campus Universitário-Monte Alegre-Ribeirão Preto, SP, Brazil CEP: 14049-900.
authors.forename: Giordana Campos
authors.initials: GC
authors.lastname: Braga
authors.forename: Milena Bastos
authors.initials: MB
authors.lastname: Brito
authors.forename: Rui Alberto
authors.initials: RA
authors.lastname: Ferriani
authors.forename: Luciana Correa
authors.initials: LC
authors.lastname: Oliveira
authors.forename: Andrea Aparecida
authors.initials: AA
authors.lastname: Garcia
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Pintão
authors.forename: Carolina Sales
authors.initials: CS
authors.lastname: Vieira
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D008598:Menstruation / Q000187:drug effects*; D011446:Prospective Studies; D019851:Thrombophilia / Q000188:drug therapy*; D054556:Venous Thromboembolism / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Anticoagulant; LNG-IUS; Thrombophilic women; Venous thrombosis