TY - JOUR
T1 - 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
AU - Khalighi, Misha
AU - Wheeler, Allison P.
AU - Adeyemi-Fowode, Oluyemisi A.
AU - Kouides, Peter A.
AU - Durazo-Arvizu, Ramon A.
AU - Haley, Kristina
AU - Dersch, Candice M.
AU - Weyand, Angela C.
AU - Baldwin, Maureen K.
AU - Borzutzky, Claudia
N1 - Publisher Copyright:
© 2022 Society for Adolescent Health and Medicine
PY - 2022/8
Y1 - 2022/8
N2 - 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.
AB - 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.
KW - Adolescent
KW - Heavy menstrual bleeding
KW - Hemorrhagic disorders
KW - Intrauterine devices
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U2 - 10.1016/j.jadohealth.2022.02.018
DO - 10.1016/j.jadohealth.2022.02.018
M3 - Article
C2 - 35430143
AN - SCOPUS:85128164389
SN - 1054-139X
VL - 71
SP - 204
EP - 209
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 2
ER -