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Self-Reported Patient's Continuation Rate, Complications, and Content (3c's Study) with Levonorgestrel Intrauterine
Avantika Gupta1, Neha Gangane1, Bishnupriya Moharana1
1OBGY Department, 54 Ajithnath Society Shatabdi Square, Nagpur, Maharashtra 440027 India.
Insights
The levonorgestrel-releasing intrauterine system (LNG-IUS) effectively treats heavy menstrual bleeding (HMB) with high patient satisfaction. This hormonal device improves quality of life and haemoglobin levels, making it a recommended option for HMB management.
Area of Science:
- Gynecology
- Reproductive Health
- Medical Devices
Background:
- Heavy menstrual bleeding (HMB) significantly impacts women's physical, emotional, and social well-being.
- The levonorgestrel-releasing intrauterine system (LNG-IUS) is a NICE-recommended first-line treatment for non-structural causes of HMB.
- Patient satisfaction is key for treatment adherence and successful management of HMB.
Purpose of the Study:
- To evaluate the continuation, expulsion, and satisfaction rates of LNG-IUS for managing HMB.
- To assess the impact of LNG-IUS on patient quality of life and haemoglobin levels.
- To provide data supporting the increased use of LNG-IUS for HMB.
Main Methods:
- A retrospective cohort study of women who received LNG-IUS for HMB between June 2021 and September 2022.
- Sample size calculated at 98, accounting for a 15% loss to follow-up.
- Evaluation of continuation, expulsion, and satisfaction rates, alongside haemoglobin level changes.
Main Results:
- 91.3% of women (80/92) were satisfied with LNG-IUS and would recommend it.
- A significant increase in mean haemoglobin from 9.35 ± 2.25 gm/dL to 10.4 ± 1.4 gm/dL at 12 months.
- Improvement in anaemia symptoms observed alongside increased haemoglobin levels.
Conclusions:
- LNG-IUS is a highly effective treatment for HMB with minimal side effects.
- Successful outcomes with LNG-IUS are associated with careful patient selection.
- Study findings can aid in counseling patients regarding abnormal uterine bleeding (AUB) management.
Background:
Heavy menstrual bleeding (HMB) affects up to one-third of women, who experience HMB at some point in their lifetime, which impacts a woman's quality of life, physically, emotionally, and socially. Aiming that treatment and management options should improve the quality of life, LNG-IUS, a hormonal device, is recommended by NICE as first-line treatment for non-structural causes of HMB, such as endometrial hyperplasia, small fibroids (3cm), or adenomyosis. Patient satisfaction is crucial, as it influences treatment adherence. We conducted our study with the primary objective to evaluate continuation rate, expulsion rate, and satisfaction rate after levonorgestrel-releasing intrauterine system (LNG-IUS) insertion for HMB, aiming to promote LNG-IUS use.
Method:
This retrospective cohort study included women who had LNG-IUS inserted for heavy menstrual bleeding between June 2021 and September 2022. Based on a 6% discontinuation rate for LNG-IUS, a 95% confidence level, and a 5% alpha error, the required sample size was 85. Accounting for a 15% loss to follow-up, the final sample size was 98.
Results:
The response was measured in all 92 women who underwent hysterectomy or expelled the device before complete follow-up. 80/92 (91.3%) were satisfied with the treatment and would recommend it to women with similar complaints. At 12-month follow-up, women had a significant increase in their mean haemoglobin values from the baseline value of 9.35 ± 2.25 gm/dL to 10.4 ± 1.4 gm/dL, and this led to improvement in symptoms of anaemia as well.
Conclusion:
LNG- IUS is highly effective in treating heavy menstrual bleeding without any major side effects; the success rate increases with good case selection. The results from the present study can be used to counsel patients with AUB.
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