ABSTRACT
Study Objective
Heavy menstrual bleeding (HMB) may be the sentinel event for identifying a patient
with a bleeding disorder (BD). The levonorgestrel intrauterine system (LNG IUS) has
been proposed as a treatment for HMB in adolescents with and without BDs; however,
no standard protocols for LNG IUS insertion in these populations exist. Providers
were surveyed regarding the use of the LNG IUS in adolescents with HMB, with and without
BD.
Design, Setting, Participants, Interventions, and Main Outcome Measures
An institutional review board−approved survey assessing provider attitudes, LNG IUS
insertion practices, and patient outcomes in adolescents with HMB, with and without
BD, was electronically distributed to 3523 providers in the fields of hematology,
adolescent medicine, and obstetrics and gynecology. Descriptive analysis was performed.
Results
A total of 312 respondents across all 3 specialties completed the survey. Nearly 100%
of respondents considered the LNG IUS safe and effective treatment for adolescents
with HMB, both with and without BD. Additionally, 66% of providers chose LNG IUS as
the ideal treatment for HMB in patients with BD. Differences were noted in clinical
setting for LNG IUS insertion, peri-procedural medication use, and post-procedure
follow-up among specialties. Providers across all specialties reported low complication
rates related to IUS insertion and use in both patient groups.
Conclusion
Providers considered the LNG IUS safe and effective treatment for HMB in adolescents
with and without a diagnosed BD. Practice patterns regarding LNG IUS insertion in
this population vary. Further research is necessary to explore IUS outcomes in adolescent
patients with HMB, with and without BD, and to inform evidence-based protocols for
LNG IUS insertion.
Key Words
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Article info
Publication history
Published online: January 22, 2021
Accepted:
January 18,
2021
Received in revised form:
November 21,
2020
Received:
August 21,
2020
Footnotes
None of the authors have any potential conflicts of interest to disclose.
Non-financial support was provided by the Foundation for Women and Girls with Blood Disorders (FWGBD). No sources of funding to disclose.
This work was published as a virtual poster presentation at the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Annual Meeting, Grapevine, TX, on April 1, 2020 (virtual poster presentation secondary to COVID-19 cancellation of in-person meeting).
Identification
Copyright
© 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
