TREATMENT OF RECURRENT REFRACTORY HYPERME NORRHOEA WITH A LEVONORGESTREL-IUS (MIRENA(R))

Objective: Is there a therapeutic effect of a local intrauterine appli cation of gestagens in patients with hypermenorrhoea, who don't respon d to oral medication? Material and Methods: In a prospective study 27 patients suffering from refractory recurrent hypermenorrhoea and who w ere admitted for transcervical endometrial ablation were treated by in sertion of a levonorgestrel-IUS (Mirena(R), Schering AG, Berlin/FRG), Results: After 12 months a success rate (reduction of pathological blo od flow) of 81% was obtained. The rate of amenorrhoea was 37%. The sup pression of the endometrial thickness measured by vaginal-sonography i s an important prognostic criterion of the success of treatment. Side effects of the levonorgestrel-IUS are low and mostly temporary (spotti ngs in the first 3 months, ovarian cysts). Conclusions: The use of int rauterine hormone system is an alternative to the endometrial ablation in patients suffering from refractory recurrent hypermenorrhoea. Espe cially in younger patients without a finalised family planing concept this local hormonal treatment should be used primarily, because it is also a safe but reversible method of contraception.