Are women satisfied when using levonorgestrel-releasing intrauterine system for treatment of abnormal uterine bleeding?

Abstract

Aim: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.Materials and 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.Conclusion: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.

Role of LNG-IUS in adenomyosis in reproductive age group women: a prospective interventional study

“…10 The overall satisfaction scores were significantly more in the LNG-IUS group as compared to the hysterectomy group with 90% women being satisfied with the treatment in the LNG-IUS group and only 50% being satisfied in the hysterectomy group. 10 A total of 70.3% patients with fibroids were satisfied and 82.4% said that they would recommend this treatment to other users as reported by Mansukhani N et al 6…”

Levonorgestrel intrauterine system: A first line medical therapy for idiopathic heavy menstrual bleeding

“…Overall, Indian studies with LNG-IUS, have consistently shown high satisfaction rates ranging from 80-96%. 5,20,21,24 Though there is no data on the efficacy and safety of LNG-IUS versus, other medical therapy, the results from Asia-Pacific study has shown superiority of LNG-IUS over conventional medical treatment. The most common reasons for discontinuation of LNG-IUS were adverse event or either bleeding.…”

“…The details of these studies are given in Table 1. 5,[19][20][21][22][23][24] Gupta et al reported 97% reduction in menstrual blood loss with LNG-IUS, at the end of one year. 20 Anemia is very common in women suffering from heavy monthly bleeding.…”

“…A multicentric, retrospective, review of patients with abnormal uterine bleeding (AUB) from Pune, Delhi, and Gurgaon has showed overall 80% patient satisfaction. 24 Kriplani et al defined patient satisfaction as patients without premature removal of the LNG-IUS. Out of 104 patients, only five patients required premature removal of LNG-IUS, indicating patient satisfaction in about 95% of patients.…”

Assessing Response of Perimenopausal Abnormal Uterine Bleeding after Treatment

“…In study by Nina manasukani et al [17] cases with adenomyosis seemed to respond very well and most of the patients were asymptomatic (52.63%) and 26.3% had amenorrhea at 6 months and 31.57% at 12 months. In many studies, though it was found that LNG IUCD is very effective in treatment of abnormal uterine bleeding, very few patients opting for IUCD in our setup as most of the patients are belonging to low socioeconomic status.…”