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Use of a levonorgestrel-releasing intrauterine device for the symptomatic treatment of uterine myomas.
J Reprod Med. 2005 Aug; 50(8):613-7.JR

Abstract

OBJECTIVE

To assess the effect of a levonorgestrel-releasing intrauterine device (LNG-IUD) for the treatment of women with uterine myomas with increased bleeding by measuring total uterine volume and by determining patient clinical improvement, uterine artery flow velocity and hemoglobin levels.

STUDY DESIGN

Ten patients with a complaint of increased uterine bleeding associated with the presence of uterine myomas were assessed in a descriptive case series and studied before and 6 months after placement of an LNG-IUD. The patients were assessed for intensity of bleeding, uterine volume, Doppler velocimetry of the uterine arteries, hematocrit and hemoglobin.

RESULTS

One patient asked to be released from the study 15 days after LNG-IUD insertion, claiming the occurrence of increased bleeding, and 2 patients underwent spontaneous expulsion of the device after 2 and 4 months of follow-up. Of the 7 patients who continued the study, 3 started to present a bleeding pattern of the oligomenorrhea type, and the other 4 experienced amenorrhea. All patients (n = 6) with anemia at the beginning of the study presented normalization of hematocrit and hemoglobin levels after 6 months of treatment (p=0.0003 and p <0.0001, respectively). However, we observed no reduction in uterine volume (p = 0.11) or flow velocity assessed by the uterine artery pulsatility index (right, p=0.17; left, p=0.19) and of the series resistance index (right, p = 0.54; left, p =0.31) using Doppler velocimetry.

CONCLUSION

Use of an LNG-IUD may be effective in controlling uterine bleeding secondary to myomatosis even in the absence of reduction of uterine volume.

Authors+Show Affiliations

Rosa e Silva JC
Department of Obstetrics and Gynecology, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, SP, Brazil. juliocrs@convex.com.br
de Sá Rosa e Silva AC
No affiliation info available
Cândido dos Reis FJ
No affiliation info available
Manetta LA
No affiliation info available
Ferriani RA
No affiliation info available
Nogueira AA
No affiliation info available

MeSH

AdultAnemiaBlood Flow VelocityContraceptive Agents, FemaleFemaleHemoglobinsHumansIntrauterine Devices, MedicatedLevonorgestrelMenorrhagiaMiddle AgedMyomaTime FactorsUterine HemorrhageUterine NeoplasmsUterus

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16220768

Citation

Rosa e Silva, Julio Cesar, et al. "Use of a Levonorgestrel-releasing Intrauterine Device for the Symptomatic Treatment of Uterine Myomas." The Journal of Reproductive Medicine, vol. 50, no. 8, 2005, pp. 613-7.
Rosa e Silva JC, de Sá Rosa e Silva AC, Cândido dos Reis FJ, et al. Use of a levonorgestrel-releasing intrauterine device for the symptomatic treatment of uterine myomas. J Reprod Med. 2005;50(8):613-7.
Rosa e Silva, J. C., de Sá Rosa e Silva, A. C., Cândido dos Reis, F. J., Manetta, L. A., Ferriani, R. A., & Nogueira, A. A. (2005). Use of a levonorgestrel-releasing intrauterine device for the symptomatic treatment of uterine myomas. The Journal of Reproductive Medicine, 50(8), 613-7.
Rosa e Silva JC, et al. Use of a Levonorgestrel-releasing Intrauterine Device for the Symptomatic Treatment of Uterine Myomas. J Reprod Med. 2005;50(8):613-7. PubMed PMID: 16220768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of a levonorgestrel-releasing intrauterine device for the symptomatic treatment of uterine myomas. AU - Rosa e Silva,Julio Cesar, AU - de Sá Rosa e Silva,Ana Carolina Japur, AU - Cândido dos Reis,Francisco Jose, AU - Manetta,Luís Alberto, AU - Ferriani,Rui Alberto, AU - Nogueira,Antônio Alberto, PY - 2005/10/14/pubmed PY - 2006/3/1/medline PY - 2005/10/14/entrez SP - 613 EP - 7 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 50 IS - 8 N2 - OBJECTIVE: To assess the effect of a levonorgestrel-releasing intrauterine device (LNG-IUD) for the treatment of women with uterine myomas with increased bleeding by measuring total uterine volume and by determining patient clinical improvement, uterine artery flow velocity and hemoglobin levels. STUDY DESIGN: Ten patients with a complaint of increased uterine bleeding associated with the presence of uterine myomas were assessed in a descriptive case series and studied before and 6 months after placement of an LNG-IUD. The patients were assessed for intensity of bleeding, uterine volume, Doppler velocimetry of the uterine arteries, hematocrit and hemoglobin. RESULTS: One patient asked to be released from the study 15 days after LNG-IUD insertion, claiming the occurrence of increased bleeding, and 2 patients underwent spontaneous expulsion of the device after 2 and 4 months of follow-up. Of the 7 patients who continued the study, 3 started to present a bleeding pattern of the oligomenorrhea type, and the other 4 experienced amenorrhea. All patients (n = 6) with anemia at the beginning of the study presented normalization of hematocrit and hemoglobin levels after 6 months of treatment (p=0.0003 and p <0.0001, respectively). However, we observed no reduction in uterine volume (p = 0.11) or flow velocity assessed by the uterine artery pulsatility index (right, p=0.17; left, p=0.19) and of the series resistance index (right, p = 0.54; left, p =0.31) using Doppler velocimetry. CONCLUSION: Use of an LNG-IUD may be effective in controlling uterine bleeding secondary to myomatosis even in the absence of reduction of uterine volume. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/16220768/Use_of_a_levonorgestrel_releasing_intrauterine_device_for_the_symptomatic_treatment_of_uterine_myomas_ DB - PRIME DP - Unbound Medicine ER -