Use of a levonorgestrel-releasing intrauterine system to treat bleeding related to uterine leiomyomas

Objective: This study was designed to evaluate the potential usefulness of the levonorgestrel-releasing intrauterine system (LNG IUS) in treating women with uterine leiomyomas. Design: Prospective before-and-after study. Setting: Family planning unit in an academic research institute. Patient(s): Sixty-seven women with uterine leiomyomas who chose the LNG IUS as their method of contraception. Intervention(s): Clinical and ultrasound examinations were performed prior to and 3, 6, and 12 months after the LNG IUS insertion. Main Outcome Measure(s): Menstrual blood loss assessed with pictorial blood loss assessment charts, ferritin and hemoglobin concentrations, and uterine and leiomyoma volume. Result(s): Use of the LNG IUS was associated with a marked reduction in menstrual blood loss. After 12 months of use, the mean pictorial blood loss assessment chart score declined from 97 to 16 (P < .001). Hemoglobin and ferritin levels increased significantly over I year of use. Eighteen of 19 women (95%) who were anemic at the beginning of the study were no longer anemic at 12 months, as judged by hemoglobin levels. No pregnancies occurred during the study. Conclusion(s): The LNG IUS was associated with a profound reduction in menstrual blood loss. For women with leiomyomas of this size, the LNG IUS provides effective medical treatment of bleeding. (C) 2003 by American Society for Reproductive Medicine.