A Levonorgestrel-Releasing Intrauterine System for the Treatment of Idiopathic Menorrhagia

Objective: To determine whether the levonorgestrel-releasing intrauterine system can safely reduce menstrual blood loss and improve quality of life in patients with idiopathic menorrhagia.Study Design: Prospective Multicentre study.Setting: Obstetrics and Gynecology Departments (King Khalid University Hospital-KSA, Enjab Hospital for infertility-UAE and Gulf Medical College and Research Centre-UAE).Patient (s): Forty patients with MBL over 80ml.Intervention (s): Insertion of the LNG-IUS on cycle days 5-7 and follow-up at 6-month intervals for 3 years.Main Outcome Measure (s): Measurement of MBL, serum ferritin, and hemoglobin for evaluation of efficacy of treatment.Result (s): A significant reduction of MBL to 36.3mL (77.9% decrease), 30.5mL (81.7% decrease), 7.9mL (95.3% decrease), and 23.5mL (85.7% decrease) at 6,12,24, and 36 months, respectively. After 6 months, one-fourth of the patients experienced amenorrhea, and one-third, spotting. Hemoglobin increased significantly from 12.2g/dl pre insertion to 13.4g/dl after 36 months, while serum ferritin levels increased significantly from 21.9ng/mL before insertion to 92.8ng/mL after 36 months.Conclusion (s): The LNG IUS was associated with a profound reduction in menstrual blood loss and the increase in hemoglobin and serum ferritin levels in the treatment of idiopathic menorrhagia.