ABSTRACT
Background
Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders of altered
collagen synthesis. People with vascular EDS are at increased risk for vascular and
hollow viscous rupture. Heavy menstrual bleeding (HMB) is common among adolescents
with EDS. The levonorgestrel intrauterine device (LNG-IUD) is an effective treatment
option for HMB; however, its use in patients with vascular EDS has historically been
avoided due to perceived risk of uterine rupture. This is the first known case report
on use of the LNG-IUD in an adolescent with vascular EDS.
Case
A 16-year-old female with vascular EDS and HMB underwent placement of the LNG-IUD.
Placement of the device was performed in the operating room under ultrasound guidance.
At the 6-month follow-up, the patient reported significant improvement in bleeding
and high satisfaction. No complications were identified at the time of placement or
follow-up.
Summary and Conclusion
LNG-IUD may be a safe and effective option for menstrual management in individuals
with vascular EDS.
Key Words
Abbreviations:
LNG-IUD (levonorgestrel intrauterine device), IUD (intrauterine device), HMB (heavy menstrual bleeding), EDS (Ehlers-Danlos Syndrome)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric and Adolescent GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ehlers-Danlos syndrome: insights on obstetric aspects.Obstet Gynecol Surv. 2007; 62: 51-57
- Gynecologic management of pediatric and adolescent patients with Ehlers-Danlos syndrome.J Pediatr Adolesc Gynecol. 2020; 33: 291-295
- Gynecologic symptoms and the influence on reproductive life in 386 women with hypermobility type Ehlers-Danlos syndrome: a cohort study.Orphanet J Rare Dis. 2016; 11: 124
- Obstetric and gynecologic challenges in women with Ehlers-Danlos syndrome.Obstet Gynecol. 2014; 123: 506-513
- Hypermobility syndromes in heavy menstrual bleeding.in: Srivaths LV Hematology in the Adolescent Female. Springer International Publishing, Springer Nature Switzerland2020: 89-98
- The type of variants at the COL3A1 gene associates with the phenotype and severity of vascular Ehlers-Danlos syndrome.Eur J Hum Genet. 2015; 23: 1657-1664
- Effectiveness and tolerability of levonorgestrel intrauterine system in adolescents.J Obstet Gynaecol. 2010; 30: 489-491
- Use of the levonorgestrel intrauterine system to treat heavy menstrual bleeding in adolescents and young adults with inherited bleeding disorders and Ehlers-Danlos syndrome.J Pediatr Adolesc Gynecol. 2022; 35 (147-152.e1)
- Pregnancy and the Ehlers–Danlos syndrome: a retrospective study in a Dutch population.Acta Obstet Gynecol Scand. 2002; 81: 293-300
- The levonorgestrel-releasing intrauterine system in heavy menstrual bleeding: a benefit-risk review.Drugs. 2012; 72: 193-215
Article info
Publication history
Published online: February 20, 2023
Accepted:
February 3,
2023
Received in revised form:
January 30,
2023
Received:
November 28,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Conflict of Interest Statement: The authors declare that they have no competing interests.
Consent for publication: The patient and family agreed in writing to the use of information pertaining to this case, including all images, for educational purposes.
Identification
Copyright
© 2023 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
