Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, PO Box 610, 00029-HUS Helsinki, Finland.
Hum Reprod. 2010 Jun;25(6):1423-7. doi: 10.1093/humrep/deq079. Epub 2010 Apr 8.
Consecutive use of the levonorgestrel-releasing intrauterine system (LNG-IUS) is increasing. However, little is known about factors that predict the bleeding during consecutive use. The objective of this study was to analyse the possible factors which may predict the bleeding pattern during the first year of use of a second LNG-IUS.
Fertile-aged women (n = 204) who had used their first LNG-IUS for over 4 years and who opted for a second LNG-IUS were recruited. Bleeding data were reported using 90-day reference periods (RPs) starting from the last 90 days of the first LNG-IUS use (baseline), until the end of the first year of the second LNG-IUS (RPs 1-4).
Demographic factors such as age, parity, body mass index, indication of LNG-IUS use or smoking could not be identified as predictors for bleeding and spotting (B/S). Mean (+/-SD) number of B/S days was 8.9 (+/-9.1) at baseline. This increased slightly during RP1 and fell to 6.4 (+/-8.1) during RP4. Compared with the mean, women with uterine fibroids or a bleeding pattern of >9 days of spotting or any bleeding at RP1 had more B/S days during RP1-4. Although the number of B/S days decreased progressively from RP1 to RP4 in the group with a bleeding pattern of >9 days of spotting or any bleeding at baseline, such a phenomenon was not observed for women with fibroids. The difference for the change in B/S days between women with and without fibroids was statistically significant at RP3 and RP4. A high degree (91.7%) of satisfaction with the bleeding pattern was observed, with amenorrhoeic women being most satisfied.
Uterine B/S is reduced during consecutive use of the LNG-IUS. Women with uterine fibroids or any bleeding at baseline continued to have more B/S than other women.
左炔诺孕酮宫内节育系统（LNG-IUS）的连续使用正在增加。然而，关于预测连续使用期间出血的因素知之甚少。本研究的目的是分析可能预测第二个 LNG-IUS 使用第一年出血模式的因素。
招募了 204 名有生育能力的妇女，她们使用第一个 LNG-IUS 超过 4 年，并选择了第二个 LNG-IUS。从第一个 LNG-IUS 使用的最后 90 天开始（基线），使用 90 天参考期（RP）报告出血数据，直到第二个 LNG-IUS 使用的第一年结束（RP1-4）。
年龄、产次、体重指数、LNG-IUS 使用指征或吸烟等人口统计学因素不能作为出血和点滴（B/S）的预测因素。基线时 B/S 天数的平均值（+/-SD）为 8.9（+/-9.1）。在 RP1 期间略有增加，在 RP4 期间降至 6.4（+/-8.1）。与平均值相比，患有子宫肌瘤或出血模式为 >9 天点滴或基线任何出血的妇女在 RP1-4 期间有更多的 B/S 天数。尽管在基线时有 >9 天点滴或任何出血的出血模式的妇女的 B/S 天数从 RP1 到 RP4 逐渐减少，但这种现象在患有子宫肌瘤的妇女中没有观察到。在 RP3 和 RP4，有和没有子宫肌瘤的妇女之间 B/S 天数变化的差异具有统计学意义。观察到高度（91.7%）对出血模式的满意度，闭经妇女最满意。
连续使用 LNG-IUS 期间子宫 B/S 减少。基线时有子宫肌瘤或任何出血的妇女比其他妇女有更多的 B/S。
