Amenorrhea and BMI as independent determinants of patient satisfaction in LNG-IUD users: Cross-sectional study in a Central European district

Abstract

Objective: This study investigated the satisfaction of women carrying the LNG-IUD and determined influencing factors, especially considering bleeding patterns and body mass index (BMI). Design: Cross sectional study. Setting: Gynecological offices in a Central European district. Participants: 1825 women aged between 18 and 60 years. Measurement: While sitting in the waiting room, voluntary patients had to answer a questionnaire about their experiences with the levonorgestrel intrauterine device. One question was used to determine whether the women were current, former or not users of the intrauterine coil. Results: 415 women who had some experiences with Mirena were found. Overall, 266 (65.7%) were “very satisfied,” 83 (20.5%) “quite satisfied,” 18 (4.4%) “moderate satisfied,” 19 (4.7%) “less satisfied,” and the same amount “really not satisfied” with the hormonal coil. Women with amenorrhea were more often “very satisfied” in general, than women with hypermenorrhea (178 (67.9%) vs. 3 (1.1%) p < 0.001). Concerning bleeding patterns, 295 (74.1%) were “very satisfied” and 23 (5.8%) “really not satisfied”. 203 (91.0%) of all amenorrhoeic women were “very satisfied” with their bleeding patterns, but only 2 (9.5%) of all women with hypermenorrhea (p < 0.001 for α = 0.05). Amenorrhea particularly occurred in women who had a significantly lower body mass index (24.4 ± 4.4 kg/m² vs. 27.6 ± 6.5 kg/m² in women with hypermenorrhea, p = 0.018 for α = 0.05). After allocating women to the widely used BMI—categories (underweight, normal weight, overweight, obese class I and II) it was evident, that normally weighted women tend toward amenorrhea as well at the beginning of LNG-IUD use as well after 4–5 years of use. In contrast to this, overweighed and obese women tend more often to amenorrhea at the end of use, but not at the beginning (72.7% and 55.6% vs. 25.0% and 0%). Women with a lower BMI were more often “very satisfied” concerning bleeding patterns, but not concerning the general satisfaction. Conclusion: Our study showed much evidence, that amenorrhea occurs more often in women with lower BMI contrary to women with a higher one—especially at the beginning of LNG- IUD use. Furthermore amenorrhea was mostly considered to be a positive menstrual change.

Keywords::

• Satisfaction
• levonorgestrel intauterine device
• bleeding patterns
• body mass index

Declaration of interest: The authors report no conflict of interest.