Impact of levonorgestrel-releasing intrauterine device on amenorrhea rates after endometrial resection or ablation in women with abnormal uterine bleeding

Objective To evaluate the impact of adjunctive levonorgestrel-releasing intrauterine device (LNG-IUD) placement on amenorrhea rates and hysterectomy risk following endometrial resection or ablation in women with abnormal uterine bleeding (AUB). Methods A retrospective cohort study was conducted involving 385 premenopausal women undergoing surgery for AUB. Patients were divided into surgery-only ( n = 238) and surgery + LNG-IUD ( n = 147) groups. Amenorrhea and hysterectomy rates were assessed at 12 months postoperatively. Multivariate logistic regression analyses were performed to examine the association of adjunctive LNG-IUD use with the risks of amenorrhea and hysterectomy, adjusting for potential confounders. Results The surgery + LNG-IUD group demonstrated a significantly higher amenorrhea rate compared to the surgery-only group (61.2% vs. 24.4%, p < 0.01) and a lower hysterectomy rate (10.2% vs. 20.2%, p < 0.01). Multivariate logistic regression showed that adjunctive LNG-IUD use independently increased the odds of amenorrhea (adjusted OR = 4.89, 95% CI: 3.07–7.78, p < 0.01) and decreased the risk of hysterectomy (adjusted OR = 0.45, 95% CI: 0.24–0.85, p = 0.01). Conclusion Adjunctive LNG-IUD placement significantly improves amenorrhea rates and reduces the risk of hysterectomy after endometrial surgery in women with AUB.