DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190970

Role of LNG-IUS in adenomyosis in reproductive age group women: a prospective interventional study

Eshna Gupta, Shashi Prateek, Poonam Mani, Lalita Yadav, Mamta Tyagi, Arushi Singh

Abstract


Background: The objective of the present study was to observe the efficacy of LNG-IUS in the treatment of heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis.

Methods: LNG-IUS was inserted in forty women between 20-50 years of age presenting with heavy menstrual bleeding and dysmenorrhoea associated with adenomyosis diagnosed on transvaginal ultrasonography and followed up after 1 month, 3 months and 6 months of insertion. Subjective assessment of menstrual blood loss was done by pictorial blood loss assessment chart and dysmenorrhoea was assessed on the basis of universal pain assessment tool and side effects were noted at each visit.

Results: Mean patients’ age was between 31-40 years (72.5%) and the follow up duration was 6 months. Significant improvements in dysmenorrhea, HMB and haemoglobin levels were observed. There was no significant change in the uterine volume. The most common side effect was prolonged vaginal spotting (n=26, 65%) and pain abdomen (n=13, 32.5%). LNG-IUS expulsion was observed in 1 patient (n=1, 2.5%). 3 patients underwent hysterectomy (n=3, 7.5%). The overall success rate of LNG-IUS was 82.5%.

Conclusions: The LNG-IUS appears to be an effective method in alleviating dysmenorrhoea and heavy menstrual bleeding associated with adenomyosis during 6 months of study. It may be a valuable long-term alternative for the treatment of adenomyosis in young and perimenopausal women and it is a good strategy to reduce the number of hysterectomies in women with adenomyosis.


Keywords


Adenomyosis, Dysmenorrhea, Levonorgestrel-releasing intrauterine system

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References


Uysal A, Taner CE, Mun S, Uysal F, Celimli FH. Use of levonorgestrel: releasing intrauterine device in the treatment of adenomyosis associated with heavy menstrual bleeding. J Pak Med Assoc. 2013; 63(11):1349-52.

Benagiano G, Brosens I. History of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):449-63.

Kepkep K, Tuncay YA, Göynümer G, Tutal E. Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? Ultrasound Obstet Gynecol. 2007;30(3):341-5.

Singh K, Bharati G, Prasad D, Kumari S. Role of levonorgestrel releasing intrauterine device in management of heavy menstrual bleeding: a conservative approach. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):631-5.

Magon N, Chauhan M, Goel P, Malik S, Kapur K, Kriplani A, Dhaliwal L, Pandit SN. Levonorgestrel intrauterine system: Current role in management of heavy menstrual bleeding. J Mid-life Health. 2013;4(1):8.

Mansukhani N, Unni J, Dua M, Darbari R, Malik S, Verma S, et al Are women satisfied when using levonorgestrel releasing intrauterine system for treatment of abnormal uterine bleeding? J Midlife Health. 2013;4(1):31-5.

Park SD, Kim M, Song T, Yun BS, Kim MK, Jun HS, et al. Clinical experiences of the levonorgestrel-releasing intrauterine system in patients with large symptomatic adenomyosis. Taiwan J Obstet Gynecol. 2015;54(4):412-5.

Garg S, Soni A. A Non-surgical lifeline for Abnormal uterine bleeding (AUB) - the LNG IUS. Ind J Obstet Gynecol Res. 2016;3(1):23-7.

Taru G, Nupur G, Sangeeta G, Pushpa B, Jyoti J, Sushma K. Levonorgestrel intrauterine system (LNG IUS) in menorrahgia: a follow-up study. Open J Obstet Gynecol. 2014;4(04):190.

Yazbeck C, Omnes S, Lavenu VMC, Madelenat P. Levonorgestrel-releasing intrauterine system in the treatment of dysfunctional uterine bleeding: A French multicenter study. Gynecol Obstet Fertil. 2006;34(10):906-13.