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The effect of the levonorgestrel intrauterine system on uterine artery blood flow 1 year after insertion
Author(s) -
Haberal A.,
Kayikcioglu F.,
Gunes M.,
Kaplan M.,
Ozdegirmenci O.
Publication year - 2006
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.2664
Subject(s) - medicine , levonorgestrel , uterine artery , gynecology , menopause , intrauterine device , endometrium , blood flow , obstetrics , urology , population , pregnancy , gestation , family planning , research methodology , environmental health , biology , genetics
Objective To assess whether the morphological alterations of the endometrium induced by the levonorgestrel intrauterine system affect the uterine artery vasculature. Methods Forty‐eight premenopausal women attending our gynecology clinic because of menorrhagia were enrolled into the study. Clinical measures of menstrual bleeding, endometrial thickness and Doppler flow of the uterine artery (resistance (RI) and pulsatility (PI) indices) were evaluated before and 1 year after insertion of the levonorgestrel intrauterine system. Thirty‐three (69%) women were available for re‐evaluation at the end of the first year and the continuation rate was 76% ( n = 25). A paired samples t ‐test and the Mann–Whitney U ‐test were used for comparison of values between groups. Results The mean age of the thirty‐three patients was 44.3 ± 7.6 years. Nine patients (27.3%) were amenorrheic and three patients were in menopause at the end of the year. After excluding the women in menopause, the increase in mean RI 1 year after insertion was statistically significant (0.86 ± 0.07 vs. 0.81 ± 0.08; P = 0.046), as was the decrease in uterine volume (736.9 ± 276.9 mL vs. 972.75 ± 465.71 mL; P = 0.029). The mean endometrial thickness decreased 1 year after insertion, but not significantly (4.6 ± 1.6 mm vs. 6.6 ± 3.5 mm; P = 0.07) and there was no statistically significant difference in mean PI between the groups (2.00 ± 0.63 and 2.03 ± 0.64 pre‐ and post‐insertion, respectively; P = 0.83). Conclusion The increase in mean RI of the uterine artery and the decrease in uterine volume 1 year after insertion of the levonorgestrel intrauterine system may be related to its progestational effect. This increase in RI may have a role in cessation of menstruation. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.