Levonorgestrel Intrauterine System in the Management of Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) is a prevalent condition among women of reproductive age––affecting approximately 10-30% of this demographic. It imposes significant challenges on women's lives, affecting their psychological, medical, social, and sexual well-being. 

A new study aimed to assess the effectiveness of a levonorgestrel intrauterine system (LNG-IUS) in managing AUB in a cohort of 100 women.

This was a retrospective analysis conducted at a private nursing home in Mumbai – spanning four years. The study included 100 women aged 30-50 years (with an average age of 42.9 years) who had undergone LNG-IUS insertion for AUB. The evaluation involved clinical examination, hemogram analysis, and transvaginal ultrasound (TVUS). Follow-up appointments were scheduled at intervals of 1 week, 1 month, 6 months, 1 year, and 2 years – to monitor bleeding patterns and the development of amenorrhea.

It was noted that 6 months after the intervention, 75% of patients experienced a reduction in menstrual blood loss. Five patients opted for removal of the LNG-IUS at the 6-month follow-up due to inadequate symptom relief. Meanwhile, 95% of patients reported full satisfaction with the LNG-IUS insertion at the end of 2 years,

From the findings, it was concluded that LNG-IUS demonstrates significant efficacy in reducing menorrhagia associated with benign conditions and proves highly effective in managing various gynecological pathologies such as – endometrial polyps, adenomyosis, and endometrial hyperplasia––particularly when inserted following dilatation and curettage/polypectomy. The LNG-IUS, containing 52 mg of levonorgestrel with a release rate of 20 μg/day, provides effective contraception for up to 5-7 years. 

Source: Ganatra A, Shah F, Ganatra K. J Obstet Gynaecol India. 2024;74(1):67-70.