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Published on: September 4, 2013
Two for the price of one
M I Samuel1, M Tenant-Flowers, U Kumar
1Department of Sexual Health and HIV, Caldecot Centre, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK. ittysamuel@hotmail.co.uk
International Journal of STD & AIDS
|October 1, 2008
Summary
The levonorgestrel-releasing intrauterine system (Mirena) effectively treated severe menorrhagia and provided contraception for an HIV-positive woman. It worked well despite antiretroviral medications, showing no adverse drug interactions.
Area of Science:
- Reproductive Endocrinology
- Infectious Diseases (HIV/AIDS)
- Pharmacology
Background:
- Severe menorrhagia and anemia in women with adenomyosis can significantly impact quality of life.
- Human Immunodeficiency Virus (HIV) infection requires management with antiretroviral therapy (ART), which can have drug-drug interactions.
- Adenomyosis is a condition where endometrial tissue grows into the muscular wall of the uterus.
Observation:
- A young woman, diagnosed as HIV seropositive, presented with severe menorrhagia and anemia secondary to adenomyosis.
- Standard treatments for menorrhagia were considered, alongside the need for effective contraception in an HIV-positive individual on ART.
Findings:
- The levonorgestrel-releasing intrauterine system (Mirena) was successfully implemented for managing severe menorrhagia.
- Mirena provided effective contraception for the patient.
- Crucially, the Mirena system demonstrated no interference with the efficacy of her liver enzyme-inducing antiretroviral medications.
Implications:
- The levonorgestrel-releasing intrauterine system is a viable and safe treatment option for menorrhagia in HIV-positive women with adenomyosis.
- This highlights the potential for intrauterine levonorgestrel devices to be used effectively in patients on enzyme-inducing ART.
- Further research could explore the long-term safety and efficacy of LNG-IUS in this specific patient population.
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