Effectiveness of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging

Author(s)

Bragheto‚ A.M. ; Caserta‚ N. ; Bahamondes‚ L. ; Petta‚ C.A.

• Document type: Journal article
• Source: Contraception; v. 76, n. 3, p. 195-199, 2007.

Abstract

Background: This study was conducted to evaluate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on adenomyotic lesions diagnosed and monitored by magnetic resonance imaging (MRI). Study Design: LNG-IUS was inserted during menstrual bleeding in 29 women, 24 to 46 years of age, with MRI-diagnosed adenomyosis associated with menorrhagia and dysmenorrhea. Clinical evaluations were carried out at baseline and at 3 and 6 months postinsertion. MRI was performed at baseline and at 6 months postinsertion and was used to calculate junctional zone thickness (in mm), to define the junctional zone borders, to identify the presence of high-signal foci on T-2-weighted images and to calculate uterine volume (in mL). Results: A significant reduction of 24.2% in junctional zone thickness was observed (p <.0001); however, no significant decrease in uterine volume was observed (142.6 mL vs. 136.4 mL; p=.2077) between baseline and the 6-month evaluation. A significant decrease in pain score was observed at 3 and 6 months after insertion (p <.0001); however, six women continued to report pain scores > 3 at 6 months of observation. At 3 months of use, the most common bleeding pattern was spotting, and at 6 months of observation, oligomenorrhea was the most common pattern observed, although spotting was present in one third of the women. Conclusions: The insertion of an LNG-TUS led to a reduction in pain and abnormal bleeding associated with adenomyosis. MRI was useful for monitoring response of adenomyotic lesions to the LNG-fUS. (c) 2007 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 03/08391-7 - Evaluation of the clinical and molecular repercussions of the use of contraceptives that contain only progestogen
• Grantee: Luis Guillermo Bahamondes
• Support Opportunities: Research Projects - Thematic Grants