Clinical Efficacy of Levonorgestrel-Releasing Intrauterine System (Mirena(R)) for Abnormal Uterine Bleeding

Han, Hyun Ju; Lee, Sung Hun; Lee, Yong Uk; Kim, Seung Ryong; Cho, Sam Hyun

Abstract

OBJECTIVE
The purpose of this study was to study the clinical efficacy of Levonorgestrel-releasing intrauterine system (Mirena(R)) for patients who have abnormal uterine bleeding before menopause or sustaining vaginal spotting during postmenopaual hormone replacement therapy.
METHODS
Between June, 2001 and June, 2003, forty six premenopausal women with abnormal uterine bleeding such as menorrhagia and intermenstrual bleeding who did not prefer surgical treatment (Group 1) and twenty four postmenopausal patients with vaginal spotting (Group 2) were included in this study. The various parameters such as uterine bleeding, dysmenorrhea, volume changes of myoma or adenomyosis, and endometrial thickness were evaluated by transvaginal ultrasound examination before and after Levonorgestrel- releasing intrauterine system usage.
RESULTS
A significant reduction in abnormal bleeding (26.3 vs 11.0) (p<0.0001) and dysmenorrhea (11.6 vs 6.1) (p<0.0001) were noticed. However, there was no significant change in volume of uterine myoma (40.0 vs 11.3) (p=0.282) and adenomyosis (103.0 vs 95.83) (p=0.266) before and after Mirena(R) insertion in Group 1. Vaginal spotting during hormone replacement therapy disappeared completely in 18/24. Also there was a significant reduction in endometrial thickness (6.3 vs 4.9) (p<0.0001) after Mirena(R) insertion in both group 1 and group 2.
CONCLUSION
Levonorgestrel-releasing intrauterine system insertion was acceptable and convenient therapeutic modality for abnormal uterine bleeding of premenopausal abnormal uterine bleeding and vaginal spotting during the postmenopausal hormone replacement therapy.