The role of levonorgestrel intrauterine device in managing abnormal uterine bleeding

Abstract

Background: Abnormal uterine bleeding (AUB) is a prevalent gynecological condition affecting menstrual regularity and quality of life, with causes ranging from structural abnormalities to hormonal imbalances. Conventional treatments, including hormonal therapy and surgery, pose challenges such as side effects, non-compliance, and fertility loss. The levonorgestrel-releasing intrauterine device (LNG-IUD) offers a minimally invasive alternative, targeting the endometrium to reduce menstrual blood loss while minimizing systemic effects.

Methods: This study evaluated the efficacy, safety, and acceptability of LNG-IUD in 52 women with AUB over 24 months. Clinical outcomes, including bleeding patterns, USG findings, complications, and satisfaction, were assessed at baseline and follow-ups (1 week, 1 month, and 6 months). Statistical analysis was conducted using SPSS v25.0.

Results: The mean age was 42.8 years, with menorrhagia (55.8%) being the most common complaint. Adenomyosis (38.5%) and thickened endometrium (30.8%) were frequent sonographic findings. At 6 months, 48% achieved amenorrhea, and spotting decreased to 36.5%. LNG-IUD retention was 88.4%, with removal in 7.6% and expulsion in 3.8%. Treatment failures led to hysterectomy (7.6%) and hormonal therapy (3.8%). Patient satisfaction was high, with 63.5% reporting being satisfied.

Conclusions: LNG-IUD proved highly effective, safe, and well-accepted for AUB management, significantly reducing menstrual blood loss and improving patient outcomes. Its high retention and satisfaction rates make it a viable alternative to systemic hormonal therapy and surgery, particularly for those seeking uterine preservation. Further studies should explore its long-term efficacy across AUB subtypes.