The Use of Levonorgestrel - IUD in the Treatment of Uterine Myoma in Thai Women
Kanok Jindabanjerd MD*, Surasak Taneepanichskul MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University
Objective : This study was designed to evaluate the potential usefulness of the levonorgestrel-releasing intrau-
terine device (LNG - IUD ; Mirena®) in treating women with uterine myomas.
Design : Prospective before-and-after (comparing) study.
Setting : Department of Obstetrics and Gynecology King Chulalongkorn Memorial Hospital.
Subjects : Sixteen women with uterine myomas who intended to receive treatment with the LNG IUD.
Intervention(s): Clinical and ultrasound examinations were performed prior to and at 1, 3 and 6 months after
the LNG IUD insertion.
Main Outcome Measures: Myoma and Uterine volume, menstrual blood loss assessed with pictorial blood
loss assessment charts and hematocrit.
Results : Use of the LNG IUD was associated with a statistically significant reduction in the total myoma
volume, average uterine size and marked reduction in menstrual blood loss. After 6 months of use, the median
total myoma volume decreased from 19.82 mL to 11.63 mL (p < 0.05), median pictorial blood loss assessment
chart score declined from 89 to 3 (p < 0.05). Hematocrit level increased over 6 months of use. The most
common side effects were bleeding disturbances (68.8%). No pregnancies occurred during the study.
Conclusion : The LNG IUD was associated with a profound reduction in myoma and uterine volume. For
women with myomas of this size, the LNG IUD provides effective medical treatment of bleeding.
Keywords : Levonorgestrel, IUD, Uterine myoma, Menstrual bleeding
