Is levonorgestrel intra-uterine system in menorrhagia: effective and acceptable? A retrospective study

Niranjana Rajan; Navina Nathan; Mala Vijayakrishnan; Usha Natarajan

doi:10.18203/2320-1770.ijrcog20260551

Authors

Niranjana Rajan Department of Obstetrics and Gynecology, Obstetrics and Gynaecology, Vijaya hospitals, Chennai, Tamil Nadu, India
Navina Nathan Department of Obstetrics and Gynecology, Obstetrics and Gynaecology, Vijaya hospitals, Chennai, Tamil Nadu, India
Mala Vijayakrishnan Department of Obstetrics and Gynecology, Obstetrics and Gynaecology, Vijaya hospitals, Chennai, Tamil Nadu, India
Usha Natarajan Department of Obstetrics and Gynecology, Obstetrics and Gynaecology, Vijaya hospitals, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20260551

Keywords:

Acceptability, Continuation rate, Dysmenorrhea, Heavy menstrual bleeding, Levonorgestrel IUS

Abstract

Background: This study aimed to evaluate the effectiveness, acceptability, satisfaction and continuation rates of the levonorgestrel intrauterine system (LNG-IUS) in women with heavy menstrual bleeding (HMB) and to assess associated adverse effects.

Methods: This retrospective study was conducted in the Department of Obstetrics and Gynaecology, Vijaya Hospital, Chennai. Fifty-five women who underwent LNG-IUS insertion for HMB between January 2023 and January 2025 were identified from outpatient records. Demographic details, co-morbidities, menstrual patterns, ultrasound findings, and histopathology reports were reviewed. Follow-up assessments at 3 and 6 months included evaluation of menstrual blood loss, dysmenorrhea, side effects, and satisfaction scores. Continuation and acceptability rates were documented. Patient satisfaction was measured on a 1-5 scale.

Results: The mean age of participants was 42.3 years, and 78% were overweight or obese. A significant reduction in menstrual blood loss was observed, with 90% showing improvement by 6 months. Amenorrhea occurred in 44%, normal bleeding in 26%, and spotting in 20% of women. Dysmenorrhea decreased from 64% at beginning to 4% at 6 months. The continuation rate was 90% and the overall satisfaction score was 74.5%. The LNG-IUS expulsion rate was 10%. The most common adverse effects were spotting (25%) and simple ovarian cysts (20%).

Conclusions: LNG-IUS is an effective, acceptable, and minimally invasive therapeutic option for HMB, offering substantial improvement in symptoms, high continuation rates, and favourable tolerability. It serves as a safe and cost-effective alternative to conventional medical and surgical treatments.

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