OBJECTIVE: To evaluate the efficacy and adverse effects of levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. METHODS: The clinical data of 75 patients with adenomyosis who had Mirena insertion in Women's Hospital,Zhejiang University School of Medicine from September 2013 to December 2013 were retrospectively analyzed. The patients were followed up to 39 months. The efficacy and adverse effects were assessed. RESULTS: Pictorial Blood Loss Assessment Chart (PBAC) scores were decreased significantly after Mirena insertion both in patients with menorrhea (118±13 vs. 29±33, <0.01) and normal menstruation (82±15 vs. 14±13, <0.01); the patients with menorrhea showed a more significant decrease in PBAC score than those with normal menstruation (90±35 vs. 69±19,<0.01). The visual analogue scale (VAS) score decreased significantly after Mirena insertion compared with pre-treatment[7(6,7) vs. 1(0,2), <0.01]. The expulsion of Mirena occurred in 18 cases (24.0%); 9 cases (12.0%) had no effect and 28 cases (37.3%) had changes of menstruation patterns. Multivariate Cox regression analysis showed that the expulsion of Mirena was not associated with post-treatment VAS score, PBAC score before and after treatment or menstrual stabilization time (all >0.05). CONCLUSIONS Mirena is effective and safe in the long term management of adenomyosis, but about one third patients may require further treatment because of the expulsion or ineffectiveness of Mirena.
Adenomyosis ; Female ; Humans ; Intrauterine Devices, Medicated ; adverse effects ; standards ; Levonorgestrel ; administration & dosage ; adverse effects ; standards ; Retrospective Studies

This paper is a result of experimental studies on family planning in Koyang county, a rural setting of Korea. The Koyang experience has shown that the acceptance of IUD is heavily dependent on two factors: the distance from the village to the IUD service clinic and the extent of side reactions: and unfavorable rumors about its use in the community. While the problem of distance was solved by sending out mobile teams or by establishing new clinics in the villages, the problem of side reaction and unfavorable rumors still remained. This study was set up to see whether the organization of mothers' classes could be a means to promote the acceptance and retention of IUDs. The mothers' class was organized in each village (hamlet), and the membership was opened to every women in the village. It was hypothesized that the mothers, class with the proper educational materials will work as an adequate educational program to offset rumors and to make a favorable social climate for accepting and retaining the IUD. The field experiment was conducted according to the "before-after" design with a control group. It was found that the educational program in the mothers' class was effective in promoting the acceptance and retention of contraceptive practice, particularly the IUD.
Adult ; Consumer Participation* ; Consumer Satisfaction* ; Family Planning ; Female ; Health Education* ; Human ; Intrauterine Devices*/standards ; Korea ; Middle Age