medigraphic.com
ISSN 0035-0052 (Print)

2024, Number 6

<< Back Next >>

Rev Mex Pediatr 2024; 91 (6)

Effectiveness of the levonorgestrel-releasing intrauterine device for abnormal uterine bleeding in adolescents with chronic disease

Rivera-Velásquez SM, Hernández-Cabezza A, Zurita-Cruz JN

Language: Spanish
References: 22
Page: 216-221
PDF size: 376.90 Kb.


ABSTRACT

Introduction: approximately 20% of adolescents experience abnormal uterine bleeding (AUB). This comorbidity can make the management of patients with chronic disease more complex. Objective: to describe the effectiveness of the hormonal intrauterine device (hIUD) in the management of AUB in adolescents with chronic diseases. Material and methods: we present the evolution of nine adolescent patients with chronic disease who presented with AUB, receiving a levonorgestrel-containing IUD. The characteristics of the menstrual disorder, previous treatments received, and response to the use of the hIUD are described. Results: the median age was 12 years. The patients had chronic kidney disease, epilepsy, coagulation disorders, intellectual disability, and/or severe anemia. Before insertion of the hIUD, five had already received hormonal treatments to control AUB. The indication for hIUD insertion was based on the World Health Organization eligibility criteria for long-acting reversible contraceptives (LARC). After insertion of the hIUD, all patients experienced a significant decrease in the amount and duration of menstrual bleeding three months after treatment. Conclusions: the hIUD is effective and safe for the management of AUB in adolescents with chronic illnesses.


REFERENCES

  1. Deligeoroglou E, Karountzos V, Creatsas G. Abnormal uterine bleeding and dysfunctional uterine bleeding in pediatric and adolescent gynecology. Gynecol Endocrinol. 2013; 29(1): 74-78. doi: 10.3109/09513590.2012.705384.

  2. Singh S, Best C, Dunn S, Leyland N, Wolfman WL; Clinical Practice – Gynaecology Committee. Abnormal uterine bleeding in pre-menopausal women. J Obstet Gynaecol Can. 2013; 35(5): 473-475. doi: 10.1016/S1701-2163(15)30939-7.

  3. Serret-Montoya J, Hernández-Cabezza A, Mendoza-Rojas O, Cárdenas-Navarrete R, Villasis-Keever MA. Alteraciones menstruales en adolescentes. Bol Med Hosp Infant Mex. 2012; 69(1): 63-76.

  4. Vygivska LA, Rudenko LA, Pliekhova OO, Rakytianskyi IY. Abnormal uterine bleeding and its causes. Literature review. Pol Merkur Lekarski. 2024; 52(4): 457-461. doi: 10.36740/Merkur202404112.

  5. Comishen KJ, Bhatt M, Yeung K, Irfan J, Zia A, Sidonio RF Jr et al. Etiology and diagnosis of heavy menstrual bleeding among adolescent and adult patients: a systematic review and meta-analysis of the literature. J Thromb Haemost. 2025; 23(3): 863-876. doi: 10.1016/j.jtha.2024.11.014.

  6. Serret-Montaya J, Zurita-Cruz JN, Villasís-Keever MA, Aguilar-Kitsu A, Del Carmen Zepeda-Martinez C, Cruz-Anleu I et al. Hyperprolactinemia as a prognostic factor for menstrual disorders in female adolescents with advanced chronic kidney disease. Pediatr Nephrol. 2020; 35(6): 1041-1049. doi: 10.1007/s00467-020-04494-7.

  7. Wildemeersch D, Andrade A, Goldstuck N. Femilis(®) 60 levonorgestrel-releasing intrauterine system-a review of 10 years of clinical experience. Clin Med Insights Reprod Health. 2016; 10: 19-27. doi: 10.4137/CMRH.S40087.

  8. Hernández-Cabezza A, Serret-Montoya J, Villasis-Keever MA, Bonilla-Rojas J, Garrido-Magaña E, Cárdenas-Navarrete R et al. Experiencia de 15 años en ginecología pediátrica y de la adolescente en un hospital pediátrico de tercer nivel. Bol Med Hosp Infant Mex. 2012; 69(5): 391-396.

  9. World Health Organization. Medical eligibility criteria for contraceptive use. 5th ed. Ginebra: World Health Organization; 2015. Available in: https://www.who.int/publications/i/item/9789241549158

  10. Kitahara Y, Hiraike O, Ishikawa H, Kugu K, Takai Y, Yoshino O et al. Diagnosis of abnormal uterine bleeding based on the FIGO classification: A systematic review and expert opinions. J Obstet Gynaecol Res. 2024; 50(10): 1785-1794. doi: 10.1111/jog.16073.

  11. Vilos GA, Tureanu V, Garcia M, Abu-Rafea B. The levonorgestrel intrauterine system is an effective treatment in women with abnormal uterine bleeding and anticoagulant therapy. J Minim Invasive Gynecol. 2009; 16(4): 480-484. doi: 10.1016/j.jmig.2009.04.018.

  12. Oliveira ECF, Baeta T, Cotta RCF, Rocha ALL. Use of 52-mg levonorgestrel-releasing intrauterine system in adolescents and young adult women: 3-year follow-up. J Pediatr Adolesc Gynecol. 2023; 36(1): 45-50. doi: 10.1016/j.jpag.2022.09.001.

  13. Krashin J, Tang JH, Mody S, Lopez LM. Hormonal and intrauterine methods for contraception for women aged 25 years and younger. Cochrane Database Syst Rev. 2015; 2015(8): CD009805. doi: 10.1002/14651858.CD009805.pub3.

  14. Callegari LS, Darney BG, Godfrey EM, Sementi O, Dunsmoor-Su R, Prager SW. Evidence-based selection of candidates for the levonorgestrel intrauterine device (IUD). J Am Board Fam Med. 2014; 27(1): 26-33. doi: 10.3122/jabfm.2014.01.130142.

  15. Pillai M, O'Brien K, Hill E. The levonorgestrel intrauterine system (Mirena) for the treatment of menstrual problems in adolescents with medical disorders, or physical or learning disabilities. BJOG. 2010; 117(2): 216-221. doi: 10.1111/j.1471-0528.2009.02372.x.

  16. Allen RH, Goldberg AB, Grimes DA. Expanding access to intrauterine contraception. Am J Obstet Gynecol. 2009; 201(5): 456.e1-5. doi: 10.1016/j.ajog.2009.04.027.

  17. Adeyemi-Fowode OA, Santos XM, Dietrich JE, Srivaths L. Levonorgestrel-releasing intrauterine device use in female adolescents with heavy menstrual bleeding and bleeding disorders: single institution review. J Pediatr Adolesc Gynecol. 2017; 30(4): 479-483. doi: 10.1016/j.jpag.2016.04.001.

  18. Alaqzam TS, Stanley AC, Simpson PM, Flood VH, Menon S. Treatment modalities in adolescents who present with heavy menstrual bleeding. J Pediatr Adolesc Gynecol. 2018; 31(5): 451-458. doi: 10.1016/j.jpag.2018.02.130.

  19. Patseadou M, Michala L. Usage of the levonorgestrel-releasing intrauterine system (LNG-IUS) in adolescence: what is the evidence so far? Arch Gynecol Obstet. 2017; 295(3): 529-541. doi: 10.1007/s00404-016-4261-0.

  20. Gemzell-Danielsson K, Buhling KJ, Dermout SM, Lukkari-Lax E, Montegriffo E, Apter D. A phase III, single-arm study of LNG-IUS 8, a low-dose levonorgestrel intrauterine contraceptive system (total content 13.5 mg) in postmenarcheal adolescents. Contraception. 2016; 93(6): 507-512. doi: 10.1016/j.contraception.2016.02.004.

  21. Zia A, Rajpurkar M. Challenges of diagnosing and managing the adolescent with heavy menstrual bleeding. Thromb Res. 2016; 143: 91-100. doi: 10.1016/j.thromres.2016.05.001.

  22. Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010; 203(2): 115.e1-7. doi: 10.1016/j.ajog.2010.04.017.




2020     |     www.medigraphic.com