Non-Contraceptive Benefits of LNG-Intrauterine System in Anemia
ESC Congress Library. Margiotte Grohmann R. May 10, 2018; 208115
Mrs. Raquel Margiotte Grohmann
Mrs. Raquel Margiotte Grohmann
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Abstract
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Objectives: Although mostly used for it's contraceptives effects, the LNG-Intrauterine system (LNG-IUS) have apositive impact in many common diseases like heavy menstrual bleeding (HMB), endometriosis, adenomiosis and endometrial hyperplasia, besides the protective effect on endometrial and ovarian cancer. In patients with sickle cell disease, the presence of other complications such as thromboembolic events, arterial hypertension and renal disease contraindicates the use of combine hormonal contraceptives. In this population, LNG-IUS may be used to improve the impact of anaemia.   Methods: Patient follow-up with diagnosis of anemia (hemolytic or sickle cell anemia) associated with some type of complication such as thrombosis, thoracic syndrome, pulmonary hypertension at the Family Planning Clinic of UNIFESP. The patients were questioned about amenorrhea, irregular uterine bleeding; acne, symptoms such as dysmenorrhea, abdominal or breast pain were also evaluated. Weight gain and laboratory tests such as hemoglobin and hematocritlevels (Hb and Ht) were also evaluated.   Results: Twenty patients with a mean age of 28.3 years were enrolled and ranged from 21 to 42 years, and 80% of them had already had at least 1 child. Regarding the duration of use, the mean length of stay was 3.75 years, with only 1 patient withdrawing the device for colic complaint (3-year use time). Regarding the symptoms, no patient complained of acne; 6% reported off-cycle abdominal pain, and 25% had dysmenorrhea. The average weight gain was a gain of 1.15 kg in the average period of permanence of the method. Analyzing the menstrual pattern, 74% progressed to amenorrhea, with 42% of all patients still experiencing occasional irregular bleeding. When studying the hematimetric indexes, there was an increase of 0.24 and 0.23 in Hb and Ht, respectively, in the average period of permanence of the method.   Conclusion: The use of SNG-IUS was considered safe among patients with sickle cell anemia, and even beneficial for the improvement of the disease, however, prospective studies with a greater number of users are required to better evaluate the effects of contraceptive methods on anemia sickle cell disease, its interactions with this disease and the use of hydroxyurea.
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