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Background <p>Endometrial polyps (EP) are a common cause of heavy menstrual bleeding (HMB). While Levonorgestrel-releasing intrauterine devices (LNG-IUDs) are effective for HMB control, their impact on EP recurrence and subsequent patient-reported outcomes, such as quality of life, remains a subject of investigation.</p> Aim <p>To evaluate the effect of LNG-IUD on symptom control, health-related quality of life (QoL), and EP recurrence in patients with HMB who were diagnosed with EP following dilatation and curettage (D&amp;C).</p> Materials and Methods <p>This retrospective cohort study included 69 women who presented with HMB and were diagnosed with EP on histopathology after D&amp;C. Following D&amp;C, all patients received an LNG-IUD. Symptoms and QoL were assessed using the Menorrhagia Multi-Attribute Scale (MMAS) and the Medical Outcomes Study 36-Item Short Form Health Survey (MOS SF-36) at baseline and at 6 and 12&#xa0;months. Patients were stratified into groups with and without polyp recurrence, as determined by follow-up ultrasonography.</p> Results <p>Over the 12-month follow-up period, the polyp recurrence rate was 14.5% (n = 10). Hemoglobin (Hb) levels significantly improved in both the recurrence and non-recurrence groups. However, significant improvements in MMAS and SF-36 scores were observed only in the non-recurrence group (<i>p</i> &lt; 0.05), with no significant change detected in the recurrence group.</p> Conclusion <p>LNG-IUD is effective for HMB control (Hb improvement) regardless of recurrence. Crucially, the full benefit of LNG-IUD on patient-reported QoL and treatment adherence is contingent upon the prevention of EP recurrence. These findings highlight the importance of recurrence-free status for achieving optimal patient outcomes.</p>

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Effects of Levonorgestrel IUD on Hemoglobin, Quality of Life, and Polyp Recurrence in Heavy Menstrual Bleeding

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Ayca Kubat Kucukyurt,
  • Selma Atiye Kolcu,
  • Betul Ozturk,
  • Ebru Kara,
  • Gulsah Ilhan

摘要

Background

Endometrial polyps (EP) are a common cause of heavy menstrual bleeding (HMB). While Levonorgestrel-releasing intrauterine devices (LNG-IUDs) are effective for HMB control, their impact on EP recurrence and subsequent patient-reported outcomes, such as quality of life, remains a subject of investigation.

Aim

To evaluate the effect of LNG-IUD on symptom control, health-related quality of life (QoL), and EP recurrence in patients with HMB who were diagnosed with EP following dilatation and curettage (D&C).

Materials and Methods

This retrospective cohort study included 69 women who presented with HMB and were diagnosed with EP on histopathology after D&C. Following D&C, all patients received an LNG-IUD. Symptoms and QoL were assessed using the Menorrhagia Multi-Attribute Scale (MMAS) and the Medical Outcomes Study 36-Item Short Form Health Survey (MOS SF-36) at baseline and at 6 and 12 months. Patients were stratified into groups with and without polyp recurrence, as determined by follow-up ultrasonography.

Results

Over the 12-month follow-up period, the polyp recurrence rate was 14.5% (n = 10). Hemoglobin (Hb) levels significantly improved in both the recurrence and non-recurrence groups. However, significant improvements in MMAS and SF-36 scores were observed only in the non-recurrence group (p < 0.05), with no significant change detected in the recurrence group.

Conclusion

LNG-IUD is effective for HMB control (Hb improvement) regardless of recurrence. Crucially, the full benefit of LNG-IUD on patient-reported QoL and treatment adherence is contingent upon the prevention of EP recurrence. These findings highlight the importance of recurrence-free status for achieving optimal patient outcomes.