The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders


Mr D. L. Economides, Royal Free Hospital, Pond Street, London NW3 2PG, UK.


Background  The levonorgestrel-releasing intrauterine system (LNG-IUS) is used commonly by gynaecologists as a contraceptive and to treat menorrhagia. However, its efficacy has not been examined in women with inherited bleeding disorders.

Design  A prospective pilot study.

Setting  A teaching hospital in north London with a designated haemophilia centre.

Population  Female patients with a known inherited bleeding disorder.

Methods  Sixteen women with subjective and objective menorrhagia caused by inherited bleeding disorders (13 von Willebrand's Disease, two factor XI deficiency and one Hermansky–Pudlak syndrome), who had previously undergone unsuccessful medical treatment were followed up for nine months after LNG-IUS insertion. Bleeding was measured by pictorial chart and haemoglobin concentration.

Main outcome measure 

Results  All women reported that their periods were improved, pictorial chart scores were lower and 56% became amenorrhoeic. None reported side effects.

Conclusion  The LNG-IUS is well tolerated and effective and improves quality of life.