Is there a difference in the clinical profile and outcome of women using Levonorgestrel IUD for abnormal uterine bleeding and those using it for contraception?: A comparative cross- sectional study

Objective: The most common indications for levonorgestrel intrauterine device (LNG-IUD) are contraception and management of abnormal uterine bleeding (AUB). This study was conducted with the aim of exploring the differences in the clinical profile and outcome of women using LNG-IUD for contraception and for AUB.
Methods: This is a retrospective comparative cross-sectional study of women had LNG-IUD (52 mg ) between 2012 to 2017 and their electronic health records were reviewed till the last follow up documented or to December 2021.
Results: Total of 235 women had LNG-IUD with age range of 21 to 62 years and a mean of (37.98 years ± 6.76). Of those women, 65.1% had it for AUB and 34.89% had it for contraception. The follow up was 1-94 months with (mean ± SEM) follow up for the AUB group of ( 21.48± 2.31) months and for contraception group was (20.74 ± 1.76 ) months (p-value of 0.80).There was a significant difference between the two groups in the age and BMI where women who had LNG-IUD for AUB were older (mean of 42.54 ± 6.49 years, P-value < 0.001) and had higher BMI ( 31.88±7.52 Kg/m2, p-value =0.011). All the LNG-IUD for contraception were inserted as out-patient. However; 68.3% of the the AUB were inserted in operating theatre in conjunction with hysteroscopy. After combining both expulsion and removal of LNG-IUD during the follow -up period; there was no significant difference between the 2 groups in the overall retention rate (p-value = 0.998).
Conclusion: this study shows that women using LNG-IUD for management of AUB are older and has higher BMI than those using it for contraception. AUB Women experienced more expulsion compared to the contraception group but there was no difference between the 2 groups in the overall survival/retention of LNG-IUD.