The Use of the Levonorgestrel-Intrauterine System (LNG-IUS) in the Treatment of Heavy MenstrualBleeding in Adolescents with Hemostatic Conditions

Science Center A255

Background: Adolescents with bleeding disorders (BD) or those that use anticoagulants are at a higher risk of heavy menstrual bleeding (HMB), which can result in a decreased quality of life. We aimed to assess the efficacy of the LNG-IUS in management of HMB in adolescents with hemostatic conditions and compare results to those in patients using combined oral contraceptive (COC) pills. Methods: A retrospective chart review was conducted of 1,597 patients who presented to our clinic for menstrual management. 62 patients were included that reported HMB, had been diagnosed with a BD or were using anticoagulants, had initiated either COC or LNG-IUS with our clinic, and followed up for at least 1 year. Results: At 1 year 71.4% of COC users reported bleeding improvement and 53.6% required a change in their medical management. 82.6% of LNG-IUS BD patients reported improvement and 21.7% required a change. 100% of LNG-IUS anticoagulant patients reported improvement and 0% required a change. There were no significant differences between hematocrit and hemoglobin levels for the COC BD and LNG-IUS BD groups, and both had a significant (P=0.01) increase when comparing the initial values to those at 1 year. Conclusions: Our pilot study supports the use of the LNG-IUS as a viable management method for adolescents with hemostatic conditions and HMB. A trend for a higher frequency of bleeding improvement was found among LNG-IUS users as compared to COC users. LNG-IUS users required fewer changes in medical management to sustain their improved bleeding symptoms.