Levonorgestrel 52 mg IUS offers rapid improvement with heavy menstrual bleeding

  • Am J Obstet Gynecol

  • von Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Women reporting heavy menstrual bleeding have a rapid and sustained decline after placement of the levonorgestrel 52 mg intrauterine system (IUS).

Why this matters

  • 30% women report heavy menstrual bleeding.
  • Levonorgestrel 52 mg IUS may be used for indications other than contraception and prevent the need for surgical treatment of heavy menstrual bleeding.
  • If patients report heavy menstrual bleeding, consider IUS with higher levonorgestrel dose.

Key results

  • 74.7% women reported no heavy menstrual bleeding after 1 cycle.
  • 15% women with baseline heavy menstrual bleeding experienced amenorrhea after 6 cycles of use (95% CI, 9.1%-20.9%).
  • Discontinuation rates in women using IUS who had baseline heavy menstrual bleeding were low.

Study design

  • Secondary cohort analysis of larger study.
  • Cohort obtained from the ACCESS IUS study, a multicenter trial evaluating the contraceptive safety and efficacy of the IUS over 10 years.
  • Women who identified as having "heavy menstrual bleeding" at baseline were included in the analysis (n=1714).
  • Funding: Medicines360.

Limitations

  • Results may not be generalizable to more diverse populations.
  • Causes of heavy menstrual bleeding were not identified.
  • Bleeding was only subjectively quantified in this study.