scholarly journals Levonorgestrel intrauterine system in menorrhagia-an effective and acceptable alternative

2021 ◽  
Vol 10 (4) ◽  
pp. 1665
Author(s):  
Barkha A. Bafna ◽  
Amit N. Bafna
Keyword(s):  
Blood Loss ◽  
Intrauterine Device ◽  
Minimal Invasive ◽  
Menstrual Blood Loss ◽  
Loss Assessment ◽  
Bleeding Pattern ◽  
Invasive Treatment ◽  
Acceptable Alternative ◽  
Fertility Sparing ◽  
Menstrual Pattern

Background: To study the efficacy, performance and acceptability of levonorgestrel intrauterine device (LNG-IUS) in treatment of women with menorrhagia.Methods: This was a descriptive, prospective and observational study conducted over a period of January 2015 to September 2020. Seventy-five (75) women presented with heavy menstrual bleeding having no contraindication for device underwent LNG-IUS insertion after consent. Menstrual pattern, pictorial blood loss assessment chart score (PBAC), rate of acceptability and satisfaction were recorded at 3 months, 6 months, 1, 2 and 3 years after insertion of LNG-IUS.Results: The most common bleeding pattern at 3 month post-insertion was inter-menstrual spotting followed by infrequent menses, oligomenorrhea and amenorrhea. LNG-IUS caused 45.19% reduction in menstrual blood loss (MBL) at 3 months, 81.48% at 1 year, 91.85% at 2 years and 97% at 3 years. Hemoglobin levels improved from mean baseline 8.9 mg/l to 12.8 mg/l at 3 years. Majority of women were satisfied with this minimally-invasive treatment with continuation rate of 94.66%. No major side-effects were noted.Conclusions: LNG-IUS is an excellent minimal invasive, highly effective in controlling blood loss and well-tolerated alternative for women with menorrhagia. Its fertility-sparing property makes it an emerging option for young women. 

scholarly journals Randomised trial of mefenamic acid versus tranexamic acid in management of menorrhagia

2017 ◽  
Vol 6 (10) ◽  
pp. 4608
Author(s):  
Madhu J. ◽  
Shylaja A. S.
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Mefenamic Acid ◽  
Randomised Trial ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
Loss Assessment ◽  
Group A ◽  
Group B ◽  
To Receive

Background: The objective of the study was to compare the efficacy of mefenamic acid, a non-inflammatory drug with tranexamic acid, an antifibrinolytic drug in management of menorrhaghia.Methods: Randomised trial of women attending outpatient department of St. Philomena’s hospital, Bangalore with complaints of menorrhagia. Fifty four patients with complaints of menorrhagia were randomly assigned to receive either mefenamic acid 500 mg tid (group A- 24 patients) or tranexamic acid 1 gm TID (group B- 26 patients) from day one to day five for three consecutive menstrual cycles.Results: Reduction in menstrual blood loss as assessed by pictoral blood loss assessment chart was more in group B (50%) than in Group A (30%) (ANOVA, covariates with F=59.647, p<0.001). Difference in improvement of dysmenorrhoea was not statistically significant (p=0.640). Side effects were less in group B compared to group A (p=0.271). Post treatment Hb% significantly improved in both groups (p=0.015 in group A, p<0.001 in gr B). Acceptability was statistically similar in both groups (p>0.05).Conclusions: Both mefenamic acid and tranexamic acid were effective in management of menorrhagia. Tranexamic acid was significantly superior to mefenamic acid in terms of reduction in menstrual blood loss.

scholarly journals Pictorial blood loss assessment chart for quantification of menstrual blood loss: a systematic review

2015 ◽  
Vol 12 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Sherif A. El-Nashar ◽  
Sherif A. M. Shazly ◽  
Abimbola O. Famuyide
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
Loss Assessment

scholarly journals LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM IN ADENOMYOSIS; PREDICTORS FOR RESPONSE AND CLINICAL OUTCOME

2018 ◽  
Vol 11 (12) ◽  
pp. 214
Author(s):  
Fadia J Alizzi ◽  
Hind Abdul Khaliq Showman ◽  
Hayder A Fawzi
Keyword(s):  
Blood Loss ◽  
Predictive Value ◽  
Intrauterine Device ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
Predictors Of Response ◽  
Duration Of Response ◽  
The Mean ◽  
Uterine Volume

Objectives: The aim is to detect clinical and ultrasonographic characters that predict the response of adenomyosis to levonorgestrel-releasing intrauterine system (LNG-IUS) and to evaluate the clinical efficacy and the time needed to show a response.Methods: A prospective single-arm study conducted in the Obstetrics and Gynaecology Department Al-Yarmouk Teaching Hospital in Baghdad/Iraq from August 2015 to March 2018. Women with symptomatic adenomyosis with age 39 years and above and who completed their families had been enrolled in this study. LNG-IUS was used as a treatment; the outcome measure was to evaluate its effect in improving the symptoms and the time needed to show a clinical response. Multivariate analysis was used to assess the contribution of the clinical and ultrasonographic parameters to the prediction of the response to LNG-IUS.Results: Over the mean duration of follow-up period of the study (22.7±9.9 months), there was a significant improvement in menstrual blood loss, dysmenorrhea, and hemoglobin (Hb) with significant decrease in uterine volume (p˂0.001). The time to show response was as early as 3 months and the first 6 months is the best time to predict failure. Initial menstrual blood loss and Hb were good predictors to show response while uterine volume an excellent one (positive predictive value 80% and negative predictive value 97.2%).Conclusion: Levonorgestrel-releasing intrauterine device is an effective treatment of symptomatic adenomyosis in term of time to response and duration of response. The presenting Hb, menstrual blood loss, and uterine volume are useful predictors of response.

scholarly journals A CASE REPORT ON EFFECTIVE MANAGEMENT OF ASRIGDARA

2020 ◽  
pp. 106-111
Author(s):  
Khushboo Jha ◽  
K. Bharathi ◽  
Sonu
Keyword(s):  
Blood Loss ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Menstrual Blood Loss ◽  
Loss Assessment ◽  
Sf 36 ◽  
Before And After ◽  
Normal Menstrual Cycle

Any uterine bleeding outside the normal volume, duration, regularity or frequency is considered as abnormal uterine bleeding (AUB). Nearly thirty percent of all gynaecological outpatient attendants are for AUB. Abnormal menstrual bleeding pattern have been traditionally expressed by terms like menorrhagia, metrorrhagia, polymenorrhagia & oligomenorrhoea. Normal menstrual cycle interval is 28 days (21-35 days), menstrual flow duration 4-5 days and normal menstrual blood loss should be 35ml (20-80 ml). Any deviation in the above criteria comes under abnormal uterine bleeding, means excessive amount of bleeding or increased duration of bleeding during menstruation or both termed as AUB. In Ayurveda same is described as Pradara. A female patient aged 22 years visited OPD of Prasuti Tantra and Stri Roga department of NIA, with complaints of heavy menstrual bleeding and prolonged menstrual bleeding more than seven days since six months. Pictorial blood loss assessment chart was used to assess the amount of blood loss before and after treatment. SF-36 questionnaire was assessed to know the improvement in quality of life. Patient was given Kutajashtakaleha 10 gm BD with cows milk.

scholarly journals Study of menstrual pattern changes in patients accepting injection depo-medroxyprogesterone acetate versus levonorgestrel intrauterine system

2021 ◽  
Vol 10 (2) ◽  
pp. 469
Author(s):  
Saloni Jain ◽  
Poonam Mani
Keyword(s):  
Blood Loss ◽  
Controlled Trial ◽  
Hormonal Contraceptive ◽  
Menstrual Bleeding ◽  
Menstrual Blood ◽  
Hormonal Contraceptives ◽  
Menstrual Blood Loss ◽  
Medical College ◽  
Menstrual Pattern ◽  
Group 2

Background: Changes in menstrual bleeding patterns are a major cause of hormonal contraceptive discontinuation. DMPA and LNG IUS both are hormonal contraceptives and are used by most of the women worldwide for various gynaecological conditions. The aim of the present study was to compare menstrual pattern changes in patients accepting injection DMPA and LNG-IUS for various gynaecological indications.Methods: This randomized controlled trial was conducted among 70 women aged 18 years or older with heavy menstrual bleeding in the department of Obstetrics and Gynaecology, Chhatrapati Shivaji Subharti Medical College, Meerut. The study comprised of two groups having 35 patients each i.e. Group 1 (patient who opted for LNG IUS) and Group 2 (patient who opted injection DMPA). The menstrual pattern changes were assessed at 1month, 3month and 6th month interval. Patient were asked to maintain a menstrual calendar wherein she would keep a record of the no. of days along with dates when she has spotting per vaginum/bleeding per vaginum and the amount of blood loss explained to her through the pictorial blood assessment chart.Results: Reduction in median menstrual blood loss was significantly greater in the LNG IUS group (-128.12mL, range -393.6 to 328.5 mL) than in the DMPA group arm -17.8 mL, range -271.5 to+78.6 mL, p<0.001).Conclusions: LNG IUS reduces menstrual blood loss more effectively than DMPA.

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