Mid-and long-term effect of levonorgestrel-releasing intrauterine system on adenomyosis

Objective To investigate the mid-and long-term outcomes and safety of inserting levonorgestrel-releasing intrauterine system/device(LNG-IUS) in patients with adenomyosis(AM).Methods LNG-IUS was used in 36 AM patients and the clinical data were kept regarding the scores of dysmenorrheal,menstrual blood volume and variation of endometrium 1 month before the insertion and the 1st to 5th year of the device setting,respectively,besides measuring the size of uterus and bilateral ovaries by transvaginal ultrasonography,determining the levels of reproductive hormone,hemoglobin,serum CA125,hepatic function and lipoprotein by morning blood test.Results Within the 1st to the 5th year of the management of AM by LNG-IUS,dysmenorrheal and menorrhagia improved significantly,with immediately elevated hemoglobin,management of anemia and reduced CA125,and the size of the uterus became shrunk and endometrium appeared thinned to a certain degree,which led to excellent management of the progress of AM.The sizes of bilateral ovaries remained as usual during the therapy and the treatment produced no significant effect on the hepatic function,lipoprotein and hormone secretion.Though minor vaginal bleeding was found as the major mid-and long-term adverse effect,all patients could virtually be tolerant.Conclusion LNG-IUS may have mid-and long-term outcomes in AM concerning its stability,economy,safety and means of conservative therapy.