Two Years Follow-Up of Patients with Abnormal Uterine Bleeding after Insertion of the Levonorgestrel-Releasing Intrauterine System

Abstract

Aim: To evaluate the efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) in the long-term treatment of heavy menstrual blood loss in women unrelated to intrauterine pathology. Methods: One hundred and six parous women aged 33–48 years with recurrent heavy menstrual bleeding (HMB) participated in this study. The women were followed up for 24 months and were assessed for intensity of bleeding both for pre- and post-insertion periods. An LNG-IUS was inserted in each patient within 7 days of the start of menstrual flow. The women were followed up at 1, 3, 6, 12, 18, and 24 months following the insertion of the intrauterine device. Results: One hundred and two women completed the follow-up period and had a significant reduction in the amount of menstrual blood loss. The LNG-IUS was well tolerated by all women. Pre-treatment of the use of the LNG-IUS, endometrial biopsy patterns for irregular proliferative endometrium and for atypical simple hyperplasia were 34/106 (32.08%) and 61/106 (57.55%) respectively and after treatment no abnormal pathologic findings were determined (p < 0.001). Conclusion: Our findings indicate that the LNG-IUS is effective for significantly reducing the amount of menstrual blood loss in women with HMB.

Assessment of patient satisfaction after levonorgestral containing intrauterine system insertion in women with abnormal uterine bleeding

“…2 It acts locally leading to high concentration of levonorgestrel in endometrium responsible for its therapeutic effect of decreasing blood loss during each cycle. 7 But it takes about six cycles to see the benefits of treatment. 6 In our study, the most common menstrual pattern at the time of presentation was menorrhagia in 38 (63.3%) followed by irregular heavy bleeding in 14 (23.4%) and polymenorrhoea in 8 (13.3%) women.…”

Impactos da utilização de dispositivos contraceptivos reversíveis de longa duração na saúde feminina

“…Apesar de alcançarem suas expectativas de reduzirem as taxas de natalidade, os LARC's apresentam atrelados a isso, alguns problemas aos seus usos como alterações na microbiota vaginal (Donders, Bellen, Ruban & Bulck;Achille, 2018), (Bassis et al, 2017); gravidez ectópica (Simon, Smith & Holzhauer, 2017); efeitos colaterais androgênicos dermatológicos (Lullo et al, 2017), abscesso pélvico causado por perfuração do colón sigmóide (Toumi et al, 2017), perfuração uterina (O'Brien & Pillai, 2017, risco de câncer de mama (Mørch et al, 2017), sangramento uterino anormal (Huss, Schaap & Kromhout, 2017), (Cim et al, 2017), (Carvalho et al, 2017), fator de risco para tratamento cirúrgico com portadores de abscesso tubo-ovário (TOA) (Inal, Inal & Gorkem, 2017), abscesso pélvico (Boisen, Ostenfeldt, Erikstrup & Bay, 2017), depressão, disfunção sexual, distúrbios menstruais (Madliki, Hofmeyr, d'Hellencourt & Lawrie, 2017), retenção do dispositivo intrauterino, expulsões reconhecidas (Colwill, Schreiber, Sammel & Sonalkar, 2017), risco de câncer cervical (Cortessis et al, 2017), migração do dispositivo intrauterino em bexiga com formação de pedra (Silva, Kodithuwakku, Aponsu, Rathnayake & Rajasegaram, 2017), (Sano, Nemoto, Miura & Suzuki, 2017), migração do dispositivo causando apendicite aguda (Parlakgumus, Parlakgumus & Ezer, 2017), translocação intra-abdominal (Uçar, Şanl‫|‬kan, Ilhan, Göçmen & Çelik, 2017), gravidez por uso prolongado (Bahamondes & Monteiro, 2017), amenorréia (Darney et al, 2017), Trichomonas vaginalis (Santos, Rigo, Macedo & Tasca, 2017), Chlamydia (Rose, Garrett, Stanley & Pullon, 2017), transmigração vesical (Chai, Zhang, Jia, Cui & Cui, 2017), (Clancy, Gerritzen & Pascali, 2017), (Sharma, Andankar & Pathak, 2017), possível toxicidade sistêmica crônica (Zhao, Liu, Sun, Hu & Wan...…”

Depressive Disorder With Panic Attacks After Replacement of an Intrauterine Device Containing Levonorgestrel: A Case Report

“…However, an increased risk of breast cancer (2) and an emerging evidence regarding mood disorders and suicide attempts (3)(4)(5)(6) arises the question of clinically relevant systemic and in particular psychotropic effects of LNG-IUS. Previous studies investigated ADRs only over a time period of 3 to 5 years after implantation (7)(8)(9). Studies on removal and insertion procedures of the second LNG-IUS mainly focused on bleeding patterns (10,11).…”