Publication:

Acceptability and clinical outcomes of levonorgestrel-releasing intrauterine system in the management of abnormal uterine bleeding among perimenopausal women: a prospective interventional study

Background The objective of the study was to evaluate the acceptability and clinical outcomes of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the management of abnormal uterine bleeding (AUB) among perimenopausal women.

Methods This prospective single-arm interventional study without a comparator group study was conducted in a tertiary care teaching hospital from March 2022 to March 2025. A total of 120 perimenopausal women aged 40-55 years presenting with AUB and opting for conservative management were enrolled. LNG-IUS was inserted following appropriate clinical evaluation and counselling. Participants were followed up at 1, 3, 6, and 12 months. Outcomes assessed included bleeding pattern, dysmenorrhea, continuation rate, expulsion, and need for hysterectomy. Data were analyzed using SPSS version 26.

Results The mean age of participants was 49.21 years, and the majority were multiparous (82.5%). Adenomyosis (53.3%) and fibroid uterus (45.0%) were the predominant etiologies. A progressive reduction in breakthrough bleeding was observed during follow-up. At one year, 30.0% of women achieved amenorrhea, while 69.2% reported light menstrual bleeding. The continuation rate of LNG-IUS at one year was 64.2%, whereas 35.8% of participants opted for hysterectomy. Device expulsion occurred in 2.5% of cases.

Conclusions LNG-IUS may serve as an effective and acceptable conservative treatment option for perimenopausal women with AUB. It significantly improves bleeding patterns and may reduce the need for surgical intervention in appropriately selected patients.