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- Title
Levonorgestrel-releasing intrauterine device to treat abnormal uterine bleeding; not one treatment option fits all.
- Authors
Atak, Zeliha; Ocakoğlu, Sakine Rahımlı; Ocakoğlu, Gökhan
- Abstract
Objective: Initially, medical treatment options are preferred in patients with abnormal uterine bleeding (AUB) who are hemodynamically stable. The aim of the present study was to investigate the effectiveness of a levonorgestrel-releasing intrauterine device (LNG-IUD) in reducing bleeding symptoms in patients with AUB stratified by underlying pathology. Material and Methods: In line with the polyp, adenomyosis, leiomyoma, malignancy (and hyperplasia), coagulopathy, ovulatory disorders, endometrial, iatrogenic and not otherwise classified classification system, patients who were administered LNG-IUD due to adenomyosis, endometrial hyperplasia, leiomyoma and AUB due to not otherwise classified causes were included in the study. Results: A total of 172 otherwise patients with a mean age of 42.58±5.00 years were included. The distributions in the adenomyosis, endometrial hyperplasia, leiomyoma and otherwise unclassified groups were 30.8%, 12.8%, 26.2%, and 30.2%, respectively. Overall effectiveness of LNG-IUD in reducing menstrual bleeding was 82%. The proportion whose bleeding decreased was 95.50% in the endometrial hyperplasia group, 88.70% in the adenomyosis group, 55.60% in the leiomyoma group and 92.30% in the not otherwise classified group. The power of the current study was 99%. The efficacy of LNG-IUD was significantly less in the leiomyoma group (p<0.05) and thus this group were more likely to require surgical intervention. The overall incidence of spotting was 50%. Amenorrhea developed in 14% of patients. Conclusion: While LNG-IUD was more effective in reducing symptoms of AUB in patients with adenomyosis, endometrial hyperplasia and not otherwise classified causes, LNG-IUD was less effective in cases of leiomyoma.
- Subjects
DRUG efficacy; ENDOMETRIOSIS; KRUSKAL-Wallis Test; STATISTICS; STATISTICAL power analysis; ENDOMETRIAL diseases; BIOPSY; HUMAN research subjects; ANALYSIS of variance; ENDOSCOPIC ultrasonography; INTRAUTERINE contraceptives; RETROSPECTIVE studies; UTERINE fibroids; AMENORRHEA; HEALTH outcome assessment; FISHER exact test; LEVONORGESTREL; INFORMED consent (Medical law); COMPARATIVE studies; METRORRHAGIA; DESCRIPTIVE statistics; DATA analysis; DATA analysis software; EVALUATION
- Publication
Journal of the Turkish-German Gynecological Association, 2023, Vol 24, Issue 4, p246
- ISSN
1309-0399
- Publication type
Article
- DOI
10.4274/jtgga.galenos.2023.2022-12-12