The effect of levonorgestrel intrauterine system on uterine myomas: a 1-year follow-up study

To assess whether levonorgestrel intrauterine system is an effective means of therapy in menorrhagia associated with myomas.

Prospective before and after study (Canadian Task Force classification II-1).

Teaching and research hospital, a tertiary center.

In all, 21 premenopausal women attending our gynecology clinic because of menorrhagia associated with uterine myomas were enrolled into the study.

Levonorgestrel-releasing intrauterine system use in uterine myomas.

Patients with myomas greater than 4 cm were excluded. Clinical assessment tools of menstrual bleeding were measured both before (pretreatment) and 1 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 1 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).

The use of the levonorgestrel intrauterine system seems to be effective in reducing menorrhagia associated with myomas with improvement in hemoglobin levels.