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

Overview

Journal J Adolesc Health

Publisher Elsevier

Specialty Pediatrics

Date 2022 Apr 17

PMID 35430143

Authors

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

Affiliations

Soon will be listed here.

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.

Citing Articles

Menstrual Disorders in Adolescence: Diagnostic and Therapeutic Challenges.

Anthon C, Steinmann M, Vidal A, Dhakal C J Clin Med. 2025; 13(24.

PMID: 39768589 PMC: 11678717. DOI: 10.3390/jcm13247668.

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