Efficacy of the levonorgestrel-releasing intrauterine system in uterine leiomyoma

Abstract

Objective To evaluate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) in reducing menstrual blood loss (MBL) in myoma-related menorrhagia and to assess the effect of the LNG-IUS on uterine and leiomyoma volume. Methods A prospective comparative study investigated the effect of LNG-IUS use in women with myoma-related menorrhagia (n = 54) and women with idiopathic menorrhagia (n = 50). The outcome was assessed in terms of reductions in MBL and in myoma and uterine volume. Results Within 1 month of LNG-IUS insertion, the Pictorial Blood Loss Assessment Chart score in the myoma group fell by 86.8% ( P < 0.0001). At 3, 12, 24, 36, and 48 months, the MBL was reduced by 92.1%, 97.4%, 97.4%, 99.5%, and 99.5%, respectively, similar to the effect seen in the idiopathic menorrhagia group. The mean uterine volume was significantly reduced in both groups, but the reduction was greater in the group with leiomyomas (idiopathic menorrhagia, P = 0.038; myoma-related menorrhagia, P = 0.012). There was no statistically significant reduction in the myoma volume ( P = 0.409). Conclusion Use of the LNG-IUS appears to lead to a significant reduction in the uterine volume of women with menorrhagia, as well as reducing the MBL in women with uterine leiomyomas.