EFFECTIVENESS OF AN INTRAUTERINE CONTRACEPTIVE CONTAINING LEVONORGESTREL (MIRENA) IN THE TREATMENT OF HEAVY MENSTRUAL BLEEDING

2021 ◽  
pp. 80-85
Author(s):  
Kalinkina O.B.
Keyword(s):  
Quality Of Life ◽  
Hormone Therapy ◽  
Hot Flashes ◽  
Abnormal Uterine Bleeding ◽  
Menopausal Hormone Therapy ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
First Line Therapy ◽  
Intrauterine Contraceptive

Levonorgestrel-containing intrauterine system Mirena refers to the first-line therapy of heavy menstrual bleeding (OMC) according to the recommendations of different countries. The efficacy, acceptability, and quality of life of women using Mirena are similar to those in the surgical treatment of abnormal uterine bleeding, including endometrial ablation and hysterectomy. The clinical case presented in this study of the management of a patient with heavy menstrual bleeding allowed us to demonstrate the effectiveness of the levonorgestrel-containing Mirena intrauterine system in OMC. The patient was observed in the consultative polyclinic of the V. D. Seredavin State Medical University. At the initial treatment, she complained of heavy menstruation, decreased performance, weight gain, and periodic increases in blood pressure. After a comprehensive clinical examination, taking into account heavy menstruation, a decrease in the quality of life, as well as the need for contraception, the introduction of the Mirena IUD was recommended. A year after the introduction of the IUD, the patient had amenorrhea. 5 years after the introduction of the Mirena IUD, the patient developed hot flashes, increased sweating, vaginal dryness, mood swings, sleep disorders, accompanied by an increase in FSH levels. The intrauterine system was removed and a new IUD - Mirena-was installed as a component of menopausal hormone therapy. After 2 months from the beginning of therapy, the complaints were completely stopped, the state of health is satisfactory, dryness in the vagina does not bother. Thus, the use of the LNG – IUD Mirena was effective for the relief of heavy menstrual bleeding, in addition, in women of this age group, it is possible to continue using the levonorgestrel-containing intrauterine system Mirena as a component of menopausal hormone therapy.

RETROSPECTIVE STUDY OF UTERINE FIBROID PATIENTS AT TERTIARY LEVEL HOSPITAL

2021 ◽  
pp. 33-35
Author(s):  
Gitika Sharma ◽  
Ranjana Atal ◽  
Vidisha Payal ◽  
Samta Bali Rathore
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Tertiary Care ◽  
Pelvic Mass ◽  
Abnormal Uterine Bleeding ◽  
Abdominal Distension ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Benign Tumours

Background: Fibroids are the most common benign tumours of the uterus. They can be asymptomatic or might present with different symptoms varied from heavy menstrual bleeding, dyspareunia, abdominal distension, or pressure-related bladder symptoms etc. Present study was done with the aim to assess the clinical features of uterine broids.Material &methods:It was a retrospective Hospital based study conducted over a period of six months in which 131 women who attended Gynecology OPD of a tertiary care teaching hospital in Rajasthan from January to June 2019 with complaints of menstrual disorders with anemia or abdomino-pelvic mass with pain and feeling heaviness in the abdomen were included.Results: Out of 131 women, 37 (28.2%) women presented to Gynecology OPD with abdomino-pelvic mass without any menstrual abnormality while 94 (71.8%) women were symptomatic. 53.4% women presented with Heavy menstrual bleeding while Dysmenorrhea (n=65; 49.6%), Fullness/heaviness in abdomen (n=61; 46.6%), Irregular period (n=57; 43.5%), Prolonged duration of menstrual bleeding (n=42; 32.0%), Constipation/bloating/diarrhoea (n=41; 31.3%) and non-menstrual pelvic pain/cramping (n=39; 29.8%) were other symptoms seen in women with broids. Conclusion : Uterine broids cause abnormal uterine bleeding and other symptoms which have negative impact on women's quality of life, affecting their sexual, social and professional life. Early diagnosis and treatment reduces morbidity and improves quality of life.

scholarly journals Levonorgesterel releasing intra uterine system in the control of heavy menstrual bleeding. Is it an alternative to hysterectomy?

2019 ◽  
Vol 8 (11) ◽  
pp. 4448
Author(s):  
Sobha S. Nair ◽  
Jayashree Nayar ◽  
Ann John Kurien ◽  
Isha Seth
Keyword(s):  
Quality Of Life ◽  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Complete Regression ◽  
Menstrual Symptoms

Background: Heavy menstrual bleeding (HMB) affects 10 to 35% of women. Studies indicate LNG-IUS which releases controlled amounts of levonorgestrel (LNG) is effective in non- surgical treatment for HMB and has fewer side effects when compared to the conventional pharmacological agents. It also improves the quality of life. Levonorgesterel releasing intra uterine system can be an alternative to hysterectomy in the control of HMB.Methods: Retrospective study of 2 years in a tertiary care centre, Kochi. 170 women with abnormal uterine bleeding were enrolled in the study. Clinical examination, routine investigations and imaging was done.  Endometrial sampling done and followed with HPE reports in indicated cases.Results: Mean age was 41 years. 30.6% had menorrhagia. Adenomyosis in 44% and endometrial hyperplasia in 19. 4%. Lost follow up in 12.9% cases and expulsion in 3.6%. 4.1% were unsatisfied and had hysterectomy. The uterine width in adenomyosis was significantly reduced p <0.012. The mean ET in endometrial hyperplasia cases also significantly reduced with p <0.01. Satisfaction rate was 97%.Conclusions: LNG-IUS is having a high success rate in controlling menstrual symptoms, thereby improving the quality of life and avoiding hysterectomy in women with abnormal uterine bleeding. It is highly efficient in symptomatic relief of adenomyosis and reduction in the uterine volume (width). Endometrial hyperplasia showed complete regression with LNG-IUS.

MENOPAUSAL HORMONOTHERAPY IN ONCOGYNECOLOGIC PATIENTS

2017 ◽  
Vol 63 (6) ◽  
pp. 843-854
Author(s):  
Olga Novikova ◽  
Yelena Ulrikh ◽  
V. Nosov ◽  
A. Charkhifalakyan
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Hormone Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Menopausal Hormone Therapy ◽  
Oncological Safety

There is presented the review of domestic and foreign references on the conserved oncological safety of the use of menopausal hormone therapy after treatment for endometrial cancer, cervical cancer, borderline and malignant ovarian tumors, various variants of sarcomas of the uterus, vulva and vaginal cancer. To the opinion of the authors the refusal to prescribe menopausal hormone therapy to patients with oncogynecologic diseases in the anamnesis is usually not justified, the category of patients, to whom hormone replacement therapy is contraindicated, is well described and mentioned in the text. In other cases sex hormones can be used to treat menopausal symptoms and improve the quality of life of patients.

O-135 Long term secondary efficacy of linzagolix for heavy menstrual bleeding (HMB) due to uterine fibroids (UF): 52-week results from two placebo-controlled, randomized, phase 3 trials

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Taylor ◽  
J Donnez ◽  
F Petraglia ◽  
K Gemzell Danielsson ◽  
S Renner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Score ◽  
Uterine Fibroids ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Phase 3 ◽  
Once Daily ◽  
Secondary Endpoints

Abstract Study question Are symptomatic improvements in women with UF observed after 24 weeks of linzagolix treatment with or without add-back therapy (ABT) maintained over 52 weeks? Summary answer Improvements in anemia, pain and quality of life previously reported at 24 weeks were maintained at 52 weeks. What is known already We previously reported that partial or full suppression of estradiol (E2) with once daily doses of either 100 or 200 mg linzagolix for 24 weeks, with or without ABT, were effective in reducing heavy menstrual bleeding associated with uterine fibroids, improving other symptoms such as pain and anemia and improving quality of life. Here we report the maintenance of effect on secondary endpoints after 52 weeks of treatment. Study design, size, duration Linzagolix is an investigational, oral GnRH antagonist being developed to treat HMB due to UF. PRIMROSE 1 (P1, USA, NCT03070899) and PRIMROSE 2 (P2, Europe and USA, NCT03070951) are randomized, double-blind, placebo-controlled Phase 3 trials, with essentially identical design, investigating the efficacy and safety of linzagolix with and without hormonal add-back therapy (ABT: 1 mg estradiol/0.5 mg norethindrone acetate) once daily for 52 weeks. Participants/materials, setting, methods Participants had HMB due to UF (&gt;80mL menstrual blood loss (MBL)/cycle) and were equally randomized to: placebo, linzagolix 100mg, linzagolix 100mg+ABT, linzagolix 200mg, or linzagolix 200mg+ABT. After 24 weeks, subjects originally randomized to placebo or linzagolix 200mg were switched to linzagolix 200mg+ABT except in P1 where 50% placebo subjects continued placebo until 52 weeks. Secondary efficacy assessments included hemoglobin, pain (0–10 numeric rating scale) and health related quality of life (HRQL) on the UF-QoL questionnaire. Main results and the role of chance P1 trial subjects (n = 526) had a mean age of 42 years, pain score of 6.6 and HRQL total score (0–100) of 36.4 and 63% were Black. P2 trial subjects (n = 511) had a mean age of 43 years, pain score 4.8 and HRQL total score of 46.1 and 5% were Black. Mean baseline MBL was about 200 mL per cycle in both studies. In both trials, significant improvements compared to placebo observed at week 24 for secondary endpoints, including pain, anemia and QoL in all linzagolix treatment groups were maintained at 52 weeks. Mean±SD hemoglobin levels in anemic patients (&lt;12 g/dL) increased from baseline by 1.7±1.9, 1.9±1.7, 2.2±2.4, 2.7±1.9 in P1 and 1.2±1.9, 2.9±1.8, 2.4±2.1, 3.0±1.4 in P2 in the 100mg, 100mg+ABT, 200mg/200mg+ABT, 200mg+ABT groups, respectively, compared to 0.6±1.8 with placebo (P1). Mean±SD change from baseline in pain scores were -3.3±3.1, -2.7±3.2, -2.6±3.0, -3.9±3.2 in P1 and -2.6±3.1, -2.6±2.8, -3.0±2.6, -2.8±3.0 in P2 in the 100mg, 100mg+ABT, 200mg/200mg+ABT, 200mg+ABT groups, respectively, compared to -0.4±2.5 with placebo (P1). Mean±SD change in HRQL total scores were 25.0±26.2, 34.2±30.1, 29.7±29.2, 38.3±29.2 in P1 and 16.8±24.0, 29.6±23.2, 31.9±26.8, 30.7±26.0 in P2 in the 100mg, 100mg+ABT, 200mg/200mg+ABT, 200mg+ABT groups, respectively, compared to 14.6±23.9 with placebo (P1). Limitations, reasons for caution Here we report data in both trials up to 52 weeks of treatment. No statistical comparisons were done at 52 weeks (the primary analysis was done after 24 weeks treatment). Post-treatment follow-up will provide more information in symptom recurrence after stopping treatment. Wider implications of the findings All linzagolix treatments provided sustained benefit. Two regimens previously identified for potential long-term treatment, 200mg with ABT and 100mg without ABT, provided sustained improvements of anemia, pain and associated quality of life. These different treatment regimens could be important to address the diverse needs of women suffering from uterine fibroids. Trial registration number ClinicalTrials.gov: NCT03070899, NCT03070951

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