Efficacy of mifepristone in reducing intermenstrual vaginal bleeding in users of the levonorgestrel intrauterine system

Abstract 

Objective

To evaluate the efficacy of mifepristone to reduce intermenstrual bleeding in levonorgestrel intrauterine system (LNG-IUS) users.

Method

In this prospective, open-label, comparative study, 36 women using the LNG-IUS for menorrhagia received 100mg of mifepristone every 30days for 3months (group 1). Fifty age-matched LNG-IUS users who did not receive any drugs were used as the comparison group (group 2). Menstrual bleeding days, pictorial blood loss assessment chart (PBAC) score, and intermenstrual bleeding/spotting days were compared between the 2 groups at 3months (during treatment) and at 6months (3months post treatment).

Results

Baseline characteristics were comparable between the groups. At 3months, median duration and episodes of intermenstrual bleeding/spotting were significantly lower in group 1 compared with group 2 (6 vs 12.5days, P=0.01; 2.5 vs 3, P=0.05, respectively). More women were satisfied with the LNG-IUS in the mifepristone group compared with the control group (75% vs 44%; P=0.004). At 6months, the median duration of intermenstrual bleeding/spotting was significantly lower in group 1 compared with group 2 (6 vs 15days; P=0.008).

Conclusion

Mifepristone was effective in reducing the number of episodes and duration of intermenstrual bleeding/spotting in LNG-IUS users.

Keywords: Intermenstrual bleeding, Levonorgestrel intrauterine system, LNG-IUS, Mifepristone, Vaginal bleeding