Satisfaction with the Levonorgestrel 19.5-mg Intrauterine Device Treatment for Heavy Menstrual Bleeding: A Pilot Study

Marco Viscola, Ana Claudia H Marcelino, Paula da Cunha Pereira, Ximena Espejo-Arce, Luis Bahamondes Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), Faculty of Medical Sciences, Campinas, SP, BrazilCorrespondence: Luis Bahamondes, Department of Obstetrics and Gynaecology, University of Campinas (UNICAMP), Faculty of Medical Sciences, Caixa Postal 6181, Campinas, SP, 13084-971, Brazil, Tel +55 19 3289 2856, Fax +55 19 3289 2440, Email bahamond@caism.unicamp.brIntroduction: Heavy menstrual bleeding (HMB) is usually treated with the levonorgestrel 52-mg intrauterine device (IUD), but if a lower-dose IUD would have similar efficacy on bleeding control mainly in the first years of use, the benefits of its dimensions could be attractive to women with narrow cervical canal. The purpose of our study was to evaluate clinical outcomes and satisfaction over one year in women with subjective complaints of HMB treated with the levonorgestrel 19.5-mg IUD.Methods: We conducted a pilot study at the Department of Obstetrics and Gynaecology, University of Campinas, Faculty of Medical Sciences, Campinas, SP, Brazil. We enrolled 73 women who consulted with complaints of HMB and accepted the use of the levonorgestrel 19.5-mg IUD. We assessed satisfaction with the IUD one year after device placement using a questionnaire that subjectively evaluated HMB through quantity, predictability, cramps, overall satisfaction, desire to continue using the IUD and the possibility of recommending it to others. Additionally, healthcare providers (HCPs) reported on the ease of insertion during device placement, and we obtained data on women’s opinions regarding pain during insertion.Results: Most women were satisfied or very satisfied with the levonorgestrel 19.5-mg IUD as a treatment for HMB, regarding bleeding quantity (n=51; 96.2%), predictability (n=43; 81.1%), and cramps (n=42; 79.2%) one year after device placement. Overall satisfaction was 98.1%. Furthermore, HCPs reported that it was easy to place (n=66; 90.4%) with varied pain at insertion.Conclusion: The levonorgestrel 19.5-mg IUD was easy to insert with varied pain at insertion, and the satisfaction of women with their bleeding pattern one year after the device placement was high or very high.Keywords: heavy menstrual bleeding, ease of placement, satisfaction, levonorgestrel intrauterine device, intrauterine device, Kyleena