Publication:

Levonorgestrel intrauterine releasing system: long term health impact

Background Menorrhagia, menstrual blood loss of more than 80 ml is a common health problem affecting 5-30% of women in India and accounts for 8% loss of economic wages annually. This study was conducted in PGIMER and Dr. RML Hospital New Delhi to evaluate the efficacy, acceptability and safety profile of LNG IUS (a non-invasive modality) in a variety of gynaecological disorders with associated menorrhagia.

Methods This was a noncomparative longitudinal observational study conducted in PGIMER and Dr RML Hospital New Delhi from June 2009 to September 2013.All patients with menorrhagia with or without dysmenorrhoea were screened and in suitable cases, LNG IUS was inserted in the postmenstrual phase after counselling and informed consent. Menstrual pattern, mean bleeding days, hemoglobin and satisfaction level was noted before insertion, 6 months, 1 year and 2 years post insertion.

Results 30 patients were recruited in the study over the first 2 years. 66.66% (20) had associated medical co morbidities. LNG IUS was spontaneously expelled in 2 (6.66%) and 3 subjects (10%) needed a hysterectomy due to persistent bleeding. The remaining 25 subjects continued with the device and these subjects had a significant decrease in mean bleeding days with associated significant rise in hemoglobin levels over 2 years.

Conclusions LNG-IUS is an underused useful device for several gynecological disorders and is a boon especially for those with medical comorbidities and should be offered to all suitable subjects.