The New Indian Journal of OBGYN. 12(1):111-116

Quality of life assessment 6 months after insertion of levonorgestrel – intrauterine system in women with abnormal uterine bleeding at a tertiary care centre

Ahana Sudhakaran, Megha Jayaprakash, Jisha Ismail

ABSTRACT

Background: The levonorgestrel- releasing intra uterine system (LNG – IUS) is now used widely for the purpose of noncontraceptive effects for conditions such as menorrhagia and dysmenorrhea. There has been limited literature regarding the effects of LNG – IUS on quality of life caused by dysmenorrhea and menorrhagia due to various gynaecological causes in females. Objectives: This study is to assess the frequency of dysmenorrhea and menorrhagia and to evaluate the quality of life and satisfaction in women treated with the (LNG – IUS) in women aged 26 to 55 years. Methods: This was a prospective observational study conducted over 1 year from the year 2018 to 2019 in women who were in the age group of 26 to 55 yrs, who have undergone treatment for abnormal uterine bleeding with levonorgestrel releasing intrauterine system, from Department of Obstetrics and Gynaecology, Government Medical College, Thrissur. They were followed up for 6 months. Data was collected using a pre-tested semi-structured interview schedule and analysed using SPSS software to assess the quality of life and patient satisfaction 6months after insertion of LNG–IUS. Results: Majority of women (58.8%) included in this study were between 36-45 years. 60.8% had bleeding lasting >7 days and 82.3% had dysmenorrhea. On endometrial sampling, majority (73.7%) of histopathology results came as secretory endometrium. On ultrasonography majority of patients 35.3% had fibroid uterus, 33.3% had thickened endometrium, and 21.6% had adenomyosis. Of the total patients studied, LNG-IUS was inplace in 94.1%, and it was expelled in 3.92%, and 1 patient underwent hysterectomy. After 6 months of insertion of LNG-IUS, 66.7% patients had complete relief of dysmenorrhea while dysmenorrhea reduced in 28.5% of patients. 56.9% had complete alleviation of AUB while bleeding reduced in 33.3%. On assessing patient satisfaction after 6 months of insertion of LNG-IUS, 90.2% were satisfied and they preferred to keep using the device, 92.2% said they would suggest LNG-IUS to others as a treatment option. Regarding general health, 66.7% felt that it was much better after 6 months of insertion of the device. In our study, there was significant improvement in physical functioning, body pain, general health, vitality, social functioning, emotional and mental health, (p value <.01, for each parameter, after 6 months of insertion of LNG –IUS. Conclusion: The LNG-IUS is an effective and well-tolerated treatment modality in abnormal uterine bleeding. The Quality of life of women treated with the LNG-IUS is markedly improved, causing high levels of patient satisfaction.