Comparative study on levonorgestrel intrauterine system and oral progestogen in women with heavy menstrual bleeding in terms of efficacy, user satisfaction and quality of life using MMAS score

Krishna Dahiya; Supriya Mahipal; Archit Dahiya; Isha Nandal; Priyanka Narang

doi:10.18203/2320-1770.ijrcog20193514

Authors

Krishna Dahiya Department of Obstetrics and Gynecology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
Supriya Mahipal Department of Obstetrics and Gynecology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
Archit Dahiya Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
Isha Nandal Department of Obstetrics and Gynaecology, SGT Medical College, Gurgaon, Haryana, India
Priyanka Narang Department of Obstetrics and Gynecology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193514

Keywords:

HMB, LNG-IUS, MMAS, PBAC, Satisfaction

Abstract

Background: To compare the efficacy, safety and user satisfaction of levonorgestrel intrauterine system (LNG-IUS) with oral progestogen in medical management of heavy menstrual bleeding (HMB).

Methods: This prospective study was conducted on 80 women with HMB in age group of 35-55 years. Patients were divided into two groups of 40 each and followed for six months. In Group I, LNG-IUS was inserted in post menstrual period and in Group II, patients received oral norethisterone 5 mg twice a day during 5th-25th day of cycle for 6 months. Patients were evaluated about amount and duration of blood loss by pictorial blood assessment chart (PBAC) along with haemoglobin estimation on each follow up visit. MMAS (Menorrhagia Multi-Attribute Scale) score comparison between two groups was done to measure the improvement in quality of life. The results were analysed by using Chi-square test and Student t-test.

Results: Percentage reduction in PBAC score after six cycles of treatment was 89.3% in LNG IUS group as compared to 68% in norethisterone group. LNG-IUS was found to be more efficient in correcting anemia, lowering duration of bleeding and improving MMAS score as compared to norethisterone.

Conclusions: Present study showed that LNG IUS was superior to oral progestogen in decreasing quantity and duration of bleeding and improving overall quality of life over time.

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