Levonorgestrel-Releasing Intrauterine Device is an Efficacious Contraceptive for Women with Leiomyoma

Women's Hospital, College of Medicine, Zhejiang University, Zhejiang, Hangzhou, China.
The Journal of international medical research (Impact Factor: 1.44). 10/2012; 40(5):1966-72. DOI: 10.1177/030006051204000538
Source: PubMed


To evaluate the efficacy of a levonorgestrel-releasing intrauterine device (LNG-IUD) as contraception for women with uterine leiomyoma.
Thirty women with uterine leiomyoma requiring contraception were enrolled and had a LNG-IUD inserted. Menstrual blood volume (assessed by a pictorial blood loss assessment chart [PBAC]), haemoglobin concentration, volume of uterus and leiomyoma were determined before and after LNG-IUD insertion.
The median (range) PBAC score was 145.0 (60.0 - 232.0) before LNG-IUD insertion, which significantly decreased to 44.0 (0.0 - 99.0) and 36.0 (0.0 - 90.0) after 6 and 12 months of LNG-IUD use, respectively. Prior to LNG-IUD insertion, the median haemoglobin concentration in patients with anaemia was 100.0 (69.0 - 109.0) g/l and this increased significantly after 6 and 12 months of LNG-IUD use, to 117.5 (101.0 - 131.0) g/l and 119.5 (108.0 - 135.0) g/l, respectively. There were no significant changes in uterine or leiomyoma volumes. No patient became pregnant and there were no severe side-effects; one IUD was expulsed.
The LNG-IUD may be a safe and effective contraceptive for women of reproductive age with uterine leiomyoma.

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    ABSTRACT: To evaluate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of leiomyoma related menorrhagia and to assess the effect of LNG-IUS on uterine, leiomyoma, and ovarian volume. In this prospective before and after study, LNG-IUS was inserted in 38 women with myoma-related menorrhagia. The patients were evaluated for serum levels of hemoglobin, hematocrit and uterine, leiomyoma, and ovarian volume at the time of insertion and at six months. Significant reduction in the Pictorial Blood Loss Assessment Chart (PBAC) score and increases in serum hemoglobin levels and in amenorrhea was observed within three months. However, there was no statistically significant reduction in the myoma and uterine volume. Ovarian volume, also, did not changed significantly. The use of LNG-IUS is effective in reducing menorrhagia associated with leiomyomas with improvement in hemoglobin levels and may be a simple and effective alternative to surgical treatment of leiomyoma-related abnormal uterine bleeding (AUB-L) without significant influence on the volume of leiomyoma and ovarian and uterine volume.
    Full-text · Article · Jun 2015 · Clinical and experimental obstetrics & gynecology