The use of levonorgestrel - IUD in the treatment of uterine myoma in Thai women.

OBJECTIVE This study was designed to evaluate the potential usefulness of the levonorgestrel-releasing intrauterine device (LNG - IUD ; Mirena) in treating women with uterine myomas. DESIGN Prospective before-and-after (comparing) study. SETTING Department of Obstetrics and Gynecology King Chulalongkorn Memorial Hospital. SUBJECTS Sixteen women with uterine myomas who intended to receive treatment with the LNG IUD. INTERVENTION(S) Clinical and ultrasound examinations were performed prior to and at 1, 3 and 6 months after the LNG IUD insertion. MAIN OUTCOME MEASURES Myoma and Uterine volume, menstrual blood loss assessed with pictorial blood loss assessment charts and hematocrit. RESULTS Use of the LNG IUD was associated with a statistically significant reduction in the total myoma volume, average uterine size and marked reduction in menstrual blood loss. After 6 months of use, the median total myoma volume decreased from 19.82 mL to 11.63 mL (p < 0.05), median pictorial blood loss assessment chart score declined from 89 to 3 (p < 0.05). Hematocrit level increased over 6 months of use. The most common side effects were bleeding disturbances (68.8%). No pregnancies occurred during the study. CONCLUSION The LNG IUD was associated with a profound reduction in myoma and uterine volume. For women with myomas of this size, the LNG IUD provides effective medical treatment of bleeding.