To determine whether the levonorgesterol releasing intra-uterine contraceptive device
can safely reduce menstrual blood loss and improve quality of life in patients with
bleeding disorders and those on oral anticoagulation.
Patients presenting with menorrhagia, without pelvic pathology and suffering from
bleeding disorder or using oral anticoagulants had Mirena inserted at Military Hospital,
Rawalpindi. Baseline hemoglobin and menstrual blood loss was evaluated using pictorial
blood assessment chart. Follow up hemoglobin and menstrual assessments were
performed at 3, 6 and 12 months. At 12 months, patient satisfaction was assessed.
Eighteen patients with bleeding disorders (3 chronic liver disease and 6 on
anticoagulation with warfarin) were included in the study. One patient was lost to follow
up after 3 months. Remaining were followed for one year. Continuity rate was 91% at
one year. Mirena resulted in decrease in menstrual blood loss by 60% at 3 months, 70%
at 6 months and 85 % at one year (p
Key words: LNG-IUS, menorrahagia, bleeding disorders, CLD.