Role of levonorgestrel releasing intrauterine device in management of heavy menstrual bleeding: A safe and effective option for all PALM COEIN variants

Introduction: Heavy menstrual bleeding (HMB) is defined as prolonged (>7 days) or excessive menstrual blood loss greater than or equal to 80 ml per menstrual cycle. Levonorgestrel-releasing intrauterine device (LNG-IUS) has become one of the most acceptable medical treatments for menorrhagia, reducing referrals to specialists and decreasing the need for operative gynecological surgery. Aim: To study the efficacy of levonorgestrel intrauterine system (LNG-IUS) in conservative management of abnormal uterine bleeding (AUB). Materials and Methods: Fifty women between 40 and 50 years with AUB were included in a study conducted over a period of 2 years. Response was assessed monthly for first 6 months and then bi annually for total 2 years. Results: LNG IUS caused 80% decrease in median menstrual blood loss (MBL) at 6 months, 95% decrease in MBL by 1 year, and 100% decrease (amenorrhea) by 2 years. Mean hemoglobin (Hb) % showed a significant rise of 10.0% from baseline 6 months post insertion. LNG IUS is as an effective alternative in women with AUB of varied etiology. Hysterectomy could be avoided in most of the women. Conclusion: LNG IUS provides an incredible nonsurgical alternative in treatment of menorrhagia.