Comparison of Oral Contraceptives and Levonorgestrel Intrauterine Device Therapy in Isthmocele-Induced Intermenstrual Bleeding
Makaleler > Tam Makale · 2025
Yazarlar: Ufuk ATLIHAN, Ferruh ACET, Onur YAVUZ, Burak ERSAK, Ali Cenk ÖZAY, Can ATA, Tevfik Berk BİLDACI, Hüseyin Aytuğ AVŞAR, Mehmet Emre PEKER, Selçuk ERKILINÇ
Türk Üreme Tıbbı ve Cerrahisi Dergisi, Uluslararası, 2025, cilt 9, ss 39-45
DOI: 10.24074/tjrms.2025-109845
Özet
Objective: To compare the effectiveness of combined contraceptives (COC) and a levonorgestrell-releasiing-intrauteriine-device (LNG-IUD) in the treatment of intermenstrual bleeding in patients with isthmocele diagnoses.Material and Methods: 104 patients who were diagnosed with isthmocele in our hospital between 2018-2024 and received COC or LNG-IUD treatment due to intermenstrual bleeding were compared retrospectively.All patients were investigated for histories of symptoms of dysmenorrhea, intermenstrual bleeding, dyspareunia, and persistent pelvic pain from patient files.Results: The mean age was significantlly hiigher in the LNG-IUD group in comparison with the COC group (p=0.042).The BMI value was significantly higher in the LNG-IUD group compared wiith the COC-group (p=0.044).The rate of smoking was significantlly hiigher in the LNG-IUD group than in the COC-group (p<0.001).The rate of intermenstrual bleeding in the 12 th -month follow-up was significantly higher in the LNG-IUD group in comparison with the COC group (p<0.001).The menstrual length in the 12 th -month follow-up was significantly lower in the LNG-IUD group compared with the COC group (p=0.048).The pelvic pain score in the 12 th -month follow-up was significantlyxlower in the LNG-IUD group than in the COCxgroup (p=0.042).Conclusion: This study provides important data comparing the efficacy of LNG-IUD and COC therapy in the treatment of intermenstrual bleeding.Although LNG-IUD appears to be more effective in reducing pelvic pain and menstrual duration, its effects on intermenstrual bleeding are more limited than COC therapy.Randomized controlled trials should be focused on investigating the mechanisms of different responses to treatment.