Levonorgestrel Intrauterine System (LNG-IUS)- First Line Treatment of AUB

Abstract

Abstract Background: Abnormal uterine bleeding (AUB) is a significant cause of hysterectomy, hence a major health problem. This study was done to evaluate the effectiveness of LNG-IUS in different indications of AUB. Materials and Methods: This was a prospective and observational study conducted at Government Medical College- A Tertiary Care Institute in Northern India over a period of 18 months from January 2019 to June 2020. A total of 40 women in the reproductive age group with AUB having no contraindication for the device, underwent LNG IUS insertion after the consent and followed up at 3,6,9, and 12 months. Results: At 3 months -24 (60%) women had a decrease in mean blood loss (MBL) and16 (40 %) continued with heavy menstrual bleeding(HMB). But most of the women complained of intermenstrual spotting, which needed time-to-time counseling. There was no expulsion and need for removal. At 12 months - 33 women continued with LNG-IUS: 25 women had a decrease in , 7 women achieved amenorrhea and 1 woman persisted with HMB. A total of 32/40 (80%) women were relieved from AUB: [25/40(62.5%) women decrease in MBL, and amenorrhea in 7/40(17.5%]. Only one/40(2.5%) women persisted with HMB, 4/40 (10%)women expelled, 2/40(5%) women got removed from the device as one wanted to conceive, and another had dyspareunia. Only one woman140(2.5%) underwent hysterectomy. The majority 32/40(80.000%) of the patients were satisfied with the treatment. The increase in Hb was less than anticipated. No major side effect was noted. Conclusion:LNG-IUS is an excellent treatment modality for patients of AUB, with good patient satisfaction. It is highly effective in controlling blood loss, well tolerated, with no need for admission, and a better alternative for hysterectomy in the reproductive age group.