Safety and bleeding patterns of the levonorgestrel 52-mg intrauterine system among women with thrombosis or coagulopathy.
Adult
Amenorrhea
/ epidemiology
Anticoagulants
/ therapeutic use
Blood Coagulation Disorders
/ drug therapy
Brazil
/ epidemiology
Contraceptive Agents, Female
/ pharmacology
Female
Humans
Intrauterine Devices, Medicated
Levonorgestrel
/ pharmacology
Menorrhagia
/ epidemiology
Oligomenorrhea
/ epidemiology
Retrospective Studies
Thromboembolism
/ drug therapy
Thrombosis
/ drug therapy
Coagulopathy
Contraception
Heavy menstrual bleeding
Levonorgestrel intrauterine system
Thromboembolism
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
24
03
2020
revised:
10
07
2020
accepted:
14
09
2020
pubmed:
24
9
2020
medline:
11
3
2021
entrez:
23
9
2020
Statut:
ppublish
Résumé
To assess the safety of the levonorgestrel 52-mg intrauterine system (LNG-IUS) in women with a history of thrombosis or coagulopathy and to evaluate bleeding patterns. A retrospective chart review was conducted of 117 women attending a clinic between 2007 and 2019. Their sociodemographic characteristics, hematologic status, reasons for using LNG-IUS, duration of use, use of oral anticoagulants, complications, and bleeding patterns were analyzed. Ninety-nine women had a history of thrombosis (71.7% in use of oral anticoagulants) and 18 had coagulopathies. No bleeding or any other complications occurred during placement of the LNG-IUS. Around two-thirds of the women reported amenorrhea or oligomenorrhea at 12, 24, and 54 months of follow-up, with no difference between the groups using the IUS for contraception or to treat heavy menstrual bleeding (HMB) (P=0.07), those with a history of thrombosis or coagulopathy (P=0.53), and users or non-users of oral anticoagulants (P=0.59). The LNG-IUS is safe for women with hematologic disorders. It was associated with amenorrhea or oligomenorrhea in a large proportion of users up to 54 months of follow-up regardless of use of oral anticoagulants, reason for use of LNG-IUS (contraception or HMB), or history of coagulopathy or thrombosis.
Substances chimiques
Anticoagulants
0
Contraceptive Agents, Female
0
Levonorgestrel
5W7SIA7YZW
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
355-361Subventions
Organisme : Fundação de Apoio à Pesquisa do Estado de São Paulo
Organisme : National Research Council
Organisme : The International Contraceptive Access Foundation
Informations de copyright
© 2020 International Federation of Gynecology and Obstetrics.
Références
Kouides PA, Kadir RA. Menorrhagia associated with laboratory abnormalities of hemostasis: Epidemiological, diagnostic and therapeutic aspects. J Thromb Haemost. 2007;5(S1):175-182.
Rodeghiero F, Castaman G, Dini E. Epidemiological investigation of the prevalence of von Willebrand's disease. Blood. 1987;69:454-459.
Jacobson-Kelly A, Vesely S, Koch T, Campbell J, O’Brien S. Von Willebrand disease screening in women undergoing hysterectomy for heavy menstrual bleeding. Haemophilia. 2019;25:188-191.
Kirtava A, Crudder S, Dilley A, Lally C, Evatt B. Trends in clinical management of women with von Willebrand disease: A survey of 75 women enrolled in haemophilia treatment centers in the United States. Haemophilia. 2004;10:158-161.
Ragni MV, Bontempo FA, Cortese Hassett AC. A von Willebrand disease and bleeding in women. Haemophilia. 1999;5:313-317.
Shankar M, Lee CA, Sabin CA, Economides DL, Kadir RA. Von Willebrand disease in women with menorrhagia: A systematic review. BJOG. 2004;111:734-740.
Friberg B, Orno A, Lindgre A, Lethagen S. Bleeding disorders among young women: A population-based prevalence study. Acta Obstet Gynecol Scand. 2006;85:200-206.
Naess IA, Christiansen SC, Romundstad P, Cannegieter SC, Rosendaal FR, Hammerstrom J. Incidence and mortality of venous thrombosis: A population-based study. J Thromb Haemost. 2007;5:692-699.
Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob G, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease. Chest. 2008;133:454-545.
Boonyawat K, O'Brien SH, Bates SM. How I treat heavy menstrual bleeding associated with anticoagulants. Blood. 2017;130:2603-2609.
Braga GC, Brito MB, Ferriani RA, et al. Oral anticoagulant therapy does not modify the bleeding pattern associated with the levonorgestrel-releasing intrauterine system in women with thrombophilia and/or a history of thrombosis. Contraception. 2014;89:48-53.
Pfeiffer S, Butts S, Dumesic D, Fossum G, Gracia C, La Barbera A. Combined hormonal contraception and the risk of venous thromboembolism: A guideline. Fertil Steril. 2017;107:43-51.
World Health Organization. Medical eligibility criteria for contraceptive use, 5th edn. Geneva: WHO; 2015.
Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2016;214:31-44.
Kingman CEC, Kadir RA, Lee CA, Economides DL. The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders. BJOG. 2004;111:1425-1428.
Kadir RA, Chi C. Levonorgestrel intrauterine system: Bleeding disorders and anticoagulant therapy. Contraception. 2007;75:123-129.
Chi C, Huq FY, Kadir RA. Levonorgestrel-releasing intrauterine system for the management of heavy menstrual bleeding in women with inherited bleeding disorders: Long-term follow-up. Contraception. 2012;83:242-247.
Schaedel ZE, Dolan G, Powell M. The use of the levonorgestrel releasing intrauterine system in the management of menorrhagia in women with hemostatic disorders. Am J Obstet Gynecol. 2005;193:1361-1363.
Pisoni CN, Cuadrado MJ, Khamashta MA, Hunt BJ. Treatment of menorrhagia associated with oral anticoagulation: Efficacy of levonorgestrel releasing intrauterine device. Thromb Res. 2005;115:121-122.
Belsey EM, Machin D, d'Arcangues C. The analysis of vaginal bleeding patterns induced by fertility regulating methods. World Health Organization Special Programme of Research, Developmentand Research Training in Human Reproduction. Contraception. 1986;34:253-260.
Rodriguez G, Faundes A, Atkinson LL. Focus on the analysis of menstrual patterns in the critical evaluation of contraceptives. Estud Poblac. 1976;1:90-97.
Qui J, Cheng J, Wang Q, Hua J. Levonorgestrel-releasing intrauterine system versus medical therapy for menorrhagia: A systematic review and meta-analysis. Med Sci Monit. 2014;20:1700-1713.
Kouides PA, Phatak PD, Burkart P, Braggins C, Cox C, Bernstein Z. Gynaecological and obstetrical morbidity in women with type I von Willebrand disease: Results of a patient survey. Haemophilia. 2000;6:643-648.
Huq FY, Tvarkova K, Arafa A, Kadir RA. Menstrual problems and contraception in women of reproductive age receiving oral anticoagulation. Contraception. 2011;84:128-132.