LEVONORGESTREL RELEASING INTRAUTERINE SYSTEM (MIRENA) FOR ABNORMAL UTERINE BLEEDING- A USEFUL TOOL IN THE COVID TIMES

Abstract

Objectives: To assess the effectiveness of the Levonorgestrel-releasing intrauterine system (LNG-IUS) in improving heavy menstrual bleeding (HMB) and evaluate satisfaction rates among women with heavy menstrual bleeding, treated with LNG–IUS. Material and methods: This prospective observational study with a one-year follow-up included 73 women of reproductive age 20 – 50 years with complaints of heavy menstrual bleeding (HMB). They presented to the Gynae ward and the outpatient department (OPD) of Khyber Teaching Hospital, Peshawar, Pakistan. Patients with more than 3 cm fibroids, pelvic inflammatory disease, bleeding of unknown cause, and any known pelvic malignancy were excluded. LNG-IUS (Mirena) was inserted in OPD routinely and in Operation Theater under anesthesia where the cervix could not be dilated. Patients were followed up in OPD at one month, 3 months, six months, and one year. Improvement in symptoms, satisfaction level, and Hemoglobin (Hb) before and after the procedure was documented on a Proforma. RESULTS: There was a progressive resolution in the amount of bleeding in patients followed at 1-month, 3-month, six months, and one year. The satisfaction rate was 92%. There was an improvement in Hb in 97% of patients. Only 04 out of 73 patients needed a hysterectomy. CONCLUSION: Levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective and tolerated treatment option for abnormal uterine bleeding. In the Covid times, it proved to be an effective first-line management of AUB. We recommend its use after careful selection of patients and also recommend a good counseling session before its use. Keywords: Abnormal uterine bleeding, heavy menstrual bleeding, LNG – IUS.