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Medical Journal Article
Levonorgestrel-releasing intrauterine device insertion ameliorates leiomyoma-dependent menorrhagia among women of reproductive age without a significant regression in the uterine and leiomyoma volumes.
Murat Naki M, Tekcan C, Ozcan N, Cebi M. Fertil Steril. 2010 Jun;94(1):371-4.A progesterone containing IUD (or “Lng-IUS”), marketed in the USA as Mirena®, has be shown to decrease or eliminate menorrhagia (heavy menstrual bleeding) in many women, and is proving for some to be a viable alternative to surgery. This study evaluated 46 women with fibroids and measured their bleeding at baseline and at 3, 6, and 12 months after insertion of the IUD. After 6 months almost 60% of women stopped having periods. This decreased to 35% at the end of 2 years. Mid-cycle bleeding decreased to approximately 10% in women with the IUD. The size of the fibroids was measured by ultrasound, and there was no decrease in size during the study period.
Comment: This study shows that although the size of fibroids did not decrease, heavy bleeding was controlled by the progesterone IUD in many women with fibroids. Women in whom the uterus was greater than the size of a 12 week pregnancy or in whom the uterine cavity was distorted by fibroids were excluded from this study. Many of the women that I see who have heavy bleeding caused by fibroids have a distorted uterine cavity and/or a uterus larger than 12 week size, and thus may not be good candidates for the IUD. The progesterone IUD does seem to be reasonable as a first-line treatment for heavy bleeding in women who don’t have fibroids or who have a relatively small uterus without a distorted cavity. — Paul Indman, M.D.
