Does a Bleeding Disorder Lessen the Efficacy of the 52-mg Levonorgestrel-Releasing Intrauterine System for Heavy Menstrual Bleeding in Adolescents? A Retrospective Multicenter Study

Misha Khalighi, Allison P. Wheeler, Oluyemisi A. Adeyemi-Fowode, Peter A. Kouides, Ramon A. Durazo-Arvizu, Kristina Haley, Candice M. Dersch, Angela C. Weyand, Maureen K. Baldwin, Claudia Borzutzky

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The aim of this study is to compare the patient-reported bleeding outcomes and complication rates with the use of the 52-mg levonorgestrel-releasing intrauterine system (52-LNG-IUS) for treatment of heavy menstrual bleeding (HMB) among adolescents with and without a diagnosed inherited bleeding disorder (BD) within the first 12 months after insertion. Methods: Retrospective chart review was conducted of adolescents ages 14–21 years, with and without an inherited BD, who underwent 52-LNG-IUS insertion between September 2013 and February 2020 for the treatment of HMB. Results: One hundred forty-four 52-LNG-IUS insertions among 139 subjects were evaluated. Fifty-nine (41%) of these were among adolescents with a diagnosed inherited BD, and 85 (59%) were among those without a BD. Among subjects with follow-up, documentation of patient-reported bleeding outcome, and a retained IUS (92/144), both groups subjectively reported improvement in bleeding outcome, with 91.7% (33/36) of those with a BD and 94.6% (53/56) of those without a BD reporting that bleeding outcome was better than prior to IUS insertion (p =.675). There was no statistically significant difference in the rate of spontaneous expulsion (p =.233), with the rate of expulsion in the first 12 months after placement among those with a BD of 13.7% (7/51) and 6.8% for those without a BD (5/72). Discussion: Adolescents with HMB both with and without an inherited BD benefit from the 52-LNG-IUS for the treatment of HMB. Rates of spontaneous IUS expulsion are not statistically different regardless of the presence of a BD and are similar to rates found in other studies of intrauterine device use in adolescents.

Original languageEnglish (US)
Pages (from-to)204-209
Number of pages6
JournalJournal of Adolescent Health
Volume71
Issue number2
DOIs
StatePublished - Aug 2022

Keywords

  • Adolescent
  • Heavy menstrual bleeding
  • Hemorrhagic disorders
  • Intrauterine devices

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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