Efficacy and Outcomes of the Hormone-Releasing Levonorgestrel-Intrauterine System for Adenomyosis Treatment

Background Adenomyosis refers to the presence of endometrial tissues within the uterine myometrium. The main presenting features are dyspareunia, dysmenorrhea, heavy menstrual bleeding (HMB), and chronic pelvic pain (CPP). With an increasing prevalence, symptomatic management is becoming more necessary. This study aimed to assess the efficacy of symptomatic relief and possible causes of failure six months after levonorgestrel-intrauterine system (LNG-IUS) insertion. Methodology This prospective, observational study was conducted over six months involving 110 patients who underwent LNG-IUS intrauterine insertion at a tertiary healthcare center and met the eligibility criteria. Pain assessment was performed using the Visual Analog Scale (VAS). HMB was assessed using the Pictorial Blood Assessment Chart, and possible causes of failure were analyzed based on uterocervical length (UCL) and uterine volume measurements. Results The VAS score before and six months after insertion of LNG-IUS was from 5.54 ± 3.10 to 1.37 ± 2.53 for dysmenorrhea, 1.75 ± 2.57 to 0.50 ± 1.57 for dyspareunia, and 1.58 ± 2.24 to 0.76 ± 1.99 for CPP. Blood loss assessment (in mL) before and after insertion was 66.73 ± 36.82 to 4.86 ± 12.88. All four assessments had p-values <0.001 and were significant. Those with significantly increased UCL and increased uterine volume had a cumulative displacement or expulsion rate of 4.54%. Conclusions This study demonstrated that LNG-IUS is highly effective in providing symptomatic relief to patients with adenomyosis. The overall satisfactory rate was 87.3%, and the failed outcome rate was 10.9%.