Patient satisfaction, sexual function and decision regret in use of levonorgestrel intrauterine device

Year 2023, , 111 - 119, 27.03.2023

Canan Satır Özel , Gökçem Büşra İnanç Karaman , Ergül Demirçivi , Oğuz Yardımcı , Mustafa Çakır , Abdulkadir Turgut

https://doi.org/10.38053/acmj.1245399

Abstract

Aim: Abnormal uterine bleeding is a common condition. The etiological cause and treatments are diverse. LNG-IUD can be used to treat abnormal uterine bleeding.It has been shown to reduce the amount of bleeding in patients with menorrhagia and increase hemoglobin and hematocrit (Hct) values. The aim is to investigate the effects of LNG-IUD on hemoglobin, Hct, bleeding pattern, and its effect on sexual function, decision regret, and menorrhagia effects according to the etiologic cause.
Material and Method: Our study included patients who underwent LNG-IUD implantation and had been using it for over six months. Patients with a history of postmenopausal or adolescent bleeding, hematologic or oncologic diseases, and a history of drug use that may cause coagulation disorders were excluded. Patients were grouped according to their indications as polyp (n=26), adenomyosis (n=16), leiomyoma (n=27), hyperplasia (n=18), and non-structural causes (n=81). Hemoglobin (Hb) and Hct values were examined before and after the application, and bleeding patterns were questioned. Participants were administered Menorrhagia Impact Questionnaire (MIQ), Arizona Sexual Experience Scale and Decision Regret Scale.
Results: 168 patients were included in our study. The average duration of LNG-IUD use was 627.0±319 days and the average age was 43.4±6.1 years. The frequency of bleeding (number of bleedings per year) was 18.0±8.0 before LNG-IUD application and 7.8±8.0 after treatment (p<0.001), and bleeding duration was 11.5±9.5 days before application and 4.8±6.2 days after application (p<0.001). The number of pads used per day was 7.7±3.9 before the application and 1.1±1.4 after the application (p<0.001). While the average Hb value was 11.2±2.0 and Hct value was 34.8±5.1 (n=112) before LNG-IUD application, the average hemogram value was 12.9±1.6 and Hct value was 39.3±4.1 (n=66) after application and a statistically significant increase was observed in Hb and Hct values (p<0.01). When the groups were compared according to the indication, there was no significant difference in the average number of days of LNG-IUD use, total Arizona score, number of individuals with sexual dysfunction according to the Arizano score and decision regret score.
Conclusion: LNG-IUD in treating patients with abnormal uterine bleeding increases Hb and Hct values and decreases the bleeding frequency, duration, and daily pad use. LNG-IUD use did not make a difference in sexual functions and decision regret according to the etiologic cause.

Keywords

bleeding pattern, Decision Regret, Levonorgestrel IUD, Sexual Function

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