Improvement of laboratory markers of anaemia in the treatment of heavy menstrual bleeding with a 19.5-mg intrauterine device: a pilot study.

OBJECTIVES

To evaluate improvements in laboratory markers of anaemia (haemoglobin, haematocrit, serum iron, and ferritin) in women with subjective heavy menstrual bleeding (HMB) treated with the levonorgestrel 19.5-mg intrauterine device.

MATERIALS AND METHODS

We conducted a pilot study at the Department of Obstetrics and Gynaecology, University of Campinas, Faculty of Medical Sciences, Campinas, SP, Brazil. We compared anaemia markers in 73 women aged 18-48 years suffering from HMB, one year after placement of the IUD.

RESULTS

The mean age of participants was 30.0 years (range 24-38); more than half were white, and the mean body mass index (kg/m) was 27.0. Twenty (27.4%) participants exited the study due to loss to follow-up ( = 12; 16.4%), expulsion ( = 7; 9.6%) and uterine perforation ( = 1; 1.4%). One-year post-IUD placement, amenorrhoea was reported by 10 (13.7%) women. According to intention-to-treat and per protocol analyses, the proportion of women with normal haemoglobin levels significantly improved ( = 0.014 in both analyses), as did haematocrit ( < 0.001 in both analyses) and serum iron ( = 0.003 in both analyses) compared to baseline evaluations. The proportion of women with normal ferritin levels also improved ( < 0.001) in both analyses using a cut-off of 15 ng/ml, though no significant difference was observed using a 30 ng/ml cut-off ( = 0.083 in both analyses).

CONCLUSION

The levonorgestrel 19.5-mg IUD effectively improved laboratory markers of anaemia one year after placement in women with HMB.