An evaluation survey of clinical performance of LNG-IUS (Mirena®) as a non-surgical long term alternate management of abnormal uterine bleeding

Abstract

Introduction: Abnormal Uterine Bleeding (AUB) refers to menstrual irregularities in frequency, regularity, duration, or volume in non-pregnant women, affecting up to one-third of women and impacting quality of life. Numerous evidences suggest that one of the very effective long-term non-surgical treatment of AUB is Levonorgestrel-releasing intrauterine device (MIRENA), however not frequently practiced. Objective: Therefore, the study was designed with an objective to determine clinical performance of 52 mg MIRENA for non-surgical long performing alternate method for AUB. Materials & Methods: A retrospective study was conducted on 118 women, aged 30 - 55 years, with no malignancies, who had been using the MIRENA (not for contraception) for at least 6 months and do not have uterine size more than 12 cm. Data were collected from military hospitals of four Indian cities including Delhi, Kolkata, Ambala and Panagarh, between 1st Jan 23 to 30th Oct 23 Participants were recalled via telephone for a review in gynecological OPDs of respective hospitals and evaluated using a pre-established proforma. Subjective perceptions were verbally noted down using a structured questionnaire. Results: The treatment resulted in significant decrease in menstrual flow of 95 patients. The hemoglobin level significantly increased. The Pictorial Blood Loss Assessment Chart (PBAC) score, dysmenorrhea and satisfaction level increased. Rates of spontaneous expulsion and hysterectomy were low. Conclusion: The use of MIRENA resulted in significant decrease in heavy menstrual bleeding in women with AUB and lead to better quality of life. It is an alternative to hysterectomy and oral medications for long term use.