ABSTRACT
Introduction
Adolescent females with developmental delays (DDs) experience unique physical and
emotional challenges related to menstruation. Providers often recommend hormonal medication
for menstrual management. The objective of our study was to describe the utilization
and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) in adolescents
with DDs.
Methods
We utilized the Pediatric Health Information System to identify females aged 10-25
with DDs who underwent an LNG-IUS insertion between 2011 and 2020. Using a gynecologic
procedure and diagnosis codes, we assessed indications for and complications of LNG-IUS
use. We also evaluated early LNG-IUS removal.
Results
One thousand five hundred and sixty female patients with DDs underwent LNG-IUS insertion.
LNG-IUS insertion under anesthesia was most commonly performed in patients with autism
and Down syndrome, and unspecified menstrual issues were documented for 40% of the
cohort. Perforation was observed in 11 patients (1%), and mechanical complications
(malpositioned IUS or lost threads) were observed in 23 patients (1%).
Discussion
This is the largest analysis of LNG-IUS use in patients with DDs to our knowledge
and shows the utilization of LNG-IUS in patients with DDs. We provide descriptive
information that providers can use to accurately advise their patients with DDs on
the risks and benefits of LNG-IUS use for menstrual management.
Key Words
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References
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Article info
Publication history
Published online: September 07, 2022
Accepted:
September 2,
2022
Received in revised form:
August 7,
2022
Received:
June 10,
2022
Footnotes
Conflict of Interest Statement: The authors have no conflicts of interest to declare.
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
