Levonorgestrel intrauterine system in menorrhagia-an effective and acceptable alternative

Background: To study the efficacy, performance and acceptability of levonorgestrel intrauterine device (LNG-IUS) in treatment of women with menorrhagia.Methods: This was a descriptive, prospective and observational study conducted over a period of January 2015 to September 2020. Seventy-five (75) women presented with heavy menstrual bleeding having no contraindication for device underwent LNG-IUS insertion after consent. Menstrual pattern, pictorial blood loss assessment chart score (PBAC), rate of acceptability and satisfaction were recorded at 3 months, 6 months, 1, 2 and 3 years after insertion of LNG-IUS.Results: The most common bleeding pattern at 3 month post-insertion was inter-menstrual spotting followed by infrequent menses, oligomenorrhea and amenorrhea. LNG-IUS caused 45.19% reduction in menstrual blood loss (MBL) at 3 months, 81.48% at 1 year, 91.85% at 2 years and 97% at 3 years. Hemoglobin levels improved from mean baseline 8.9 mg/l to 12.8 mg/l at 3 years. Majority of women were satisfied with this minimally-invasive treatment with continuation rate of 94.66%. No major side-effects were noted.Conclusions: LNG-IUS is an excellent minimal invasive, highly effective in controlling blood loss and well-tolerated alternative for women with menorrhagia. Its fertility-sparing property makes it an emerging option for young women.

Tackling gynecological health problems in adolescent girls of rural India: need of the hour

Background: Adolescence is a transient and dynamic period characterised by several changes in the child’s body and mind. Onset of menarche is major physiological milestone in adolescent girls which is often associated with menstrual irregularities and other hormonal events. Aim of the present study was to evaluate the profile of adolescent girls attending the outpatient clinic.Methods: This hospital based cross-sectional, prospective, observational study was conducted at Bafna hospital from January 2019 to December 2020. We analysed 220 consecutive adolescent girls with gynaecological health issues. The data was collected and analysed using pre-designed questionnaire.Results: Menstrual disorders (64.5%) were most common followed by teenage pregnancies (20.9%). Other complaints included vulvar disorders, breast diseases, genital trauma, hirsuitism, UTI and psychological problems. Anemia (28.1%) and PCOS (30.9%) were also diagnosed. Hormonal treatment was offered to 59.5% girls whereas surgical intervention done in 4% for various indications.Conclusions: Menstrual disorders, teenage pregnancies, PCOS and anemia were the most common issues seen. Adolescent gynaecological problems are unique and specific regarding presentation, diagnosis and treatment options. It is important to tackle them on top priority due to its impact on future reproductive health