Study Objective

To describe the bleeding patterns associated with the use of the levonorgestrel intrauterine device (IUD) in adolescents.

Design, Setting, and Participants

A retrospective chart review of postmenarchal adolescent patients ages 8-19 years who had the levonorgestrel IUD inserted at Phoenix Children's Hospital from 2012 to 2018.

Interventions

Insertion of the 52-mg and 13.5-mg levonorgestrel IUD.

Main Outcome Measures

The rate of amenorrhea and other bleeding patterns after insertion of the levonorgestrel IUD and the factors that might predict those bleeding patterns.

Results

A total of 260 charts were identified with 221/260 (85.0%) patients choosing the 52-mg IUD and 39/260 (15.0%) patients choosing the 13.5-mg IUD to be inserted. Follow-up data were available for 166 patients. The overall rate of amenorrhea among IUD users was 39.8% (n = 66) with no difference between 52-mg and 13.5-mg IUD users (P = .656). Regularity and flow of menstrual cycle, history of bleeding disorder, history of developmental delay, and current treatment with testosterone for gender dysphoria before IUD insertion did not appear to have a significant effect on the rate of amenorrhea or bleeding patterns post-IUD insertion.

Conclusion

The levonorgestrel IUD can be successfully used to control abnormal uterine bleeding and suppress menses in adolescents. Menstrual cycle characteristics pre-IUD insertion did not result in predictable post-IUD bleeding patterns.

中文翻译：

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使用左炔诺孕酮宫内节育器在青少年中的出血模式：单机构审查。

研究目标

描述与青少年使用左炔诺孕酮宫内节育器（IUD）相关的出血模式。

设计，设置和参与者

回顾性图表回顾了2012年至2018年在凤凰城儿童医院插入了左炔诺孕酮宫内节育器的8-19岁的月经后青春期患者。

干预措施

插入52 mg和13.5 mg左炔诺孕酮宫内节育器。

主要观察指标

左炔诺孕酮宫内节育器插入后的闭经率和其他出血模式以及可能预测这些出血模式的因素。

结果

总共鉴定出260张图表，其中221/260（85.0％）位患者选择52 mg IUD，39/260（15.0％）位患者选择13.5 mg IUD。有166例患者的随访数据。宫内节育器使用者的总体闭经率为39.8％（n = 66），在52毫克和13.5毫克宫内节育器使用者之间无差异（P  = .656）。月经周期的规律性和流量，出血性疾病的病史，发育迟缓的病史以及目前在IUD插入前用睾丸激素治疗性别不安的方法似乎对IUD插入后的闭经率或出血模式没有明显影响。

结论

左炔诺孕酮宫内节育器可成功用于控制异常子宫出血并抑制青少年的月经。IUD插入前的月经周期特征并未导致可预测的IUD后出血模式。