The Effect of Levonorgestrel Intrauterine System on Uterine Myomas: A 1-Year Follow-up Study

Study Objective: To assess whether levonorgestrel intrauterine system is an effective means of therapy in menorrhagia associated with myomas. Design: Prospective before and after study (Canadian Task Force classification II-1). Setting: Teaching and research hospital, a tertiary center. Patients: In all, 2 1 premenopausal women attending our gynecology clinic because of menorrhagia associated with uterine myomas were enrolled into the study. Interventions: Levonorgestrel-releasing intrauterine system use in uterine myomas. Measurements and Main Results: Patients with myomas greater than 4 cm were excluded. Clinical assessment tools of menstrual bleeding were measured both before (pretreatment) and I year after the insertion (posttreatment). A P value less than or equal to .05 was considered statistically significant for menstrual blood loss as a primary Outcome and Bonferroni correction was done for secondary outcomes as 0.01. The mean age of the patients was 47.05 +/- 4.9 years. At 1-year follow-up, 5 women had had a hysterectomy. Four patients were amenorrheic. The duration of menstruation and the mean endometrial thickness were decreased I year after insertion; these decreases were not statistically significant (p = .034 and p = .204, respectively). While the mean number of pads used daily during menstruation decreased (p = .011), the hemoglobin level was increased (p = .001). A reduction in mean uterine Volume and increase in ferritin levels were observed, but these changes did not reach statistical significance (p = .050 and p = .036, respectively). Conclusion: The use of the levonorgestrel intrauterine system seems to be effective in reducing menorrhagia associated with myomas with improvement in hemoglobin levels. Journal of Minimally Invasive Gynecology (2008) 15, 735-738 (C) 2008 AAGL. All rights reserved.