Menstrual Pattern Modulation Following Levonorgestrel Intrauterine System Use in Symptomatic Adenomyosis Patients

Background: Adenomyosis is a chronic gynecological condition characterized by dysmenorrhea and heavy menstrual bleeding thatsignificantly affects reproductive-aged women. Conservative management strategies that preserve fertility have gained attention dueto limitations associated with surgical treatment. The levonorgestrel-releasing intrauterine system has emerged as an effectivetherapeutic option by delivering localized progestin effects within the uterus. Objective: To evaluate menstrual pattern modulationfollowing levonorgestrel intrauterine system use among symptomatic adenomyosis patients. Methods: A quasi-experimental studywas conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, from August 2023 to July 2024. Thirty women aged 25–45 years with symptomatic adenomyosis were enrolled. Baseline clinical assessment, transvaginal ultrasonography, hemoglobinestimation and visual analog scale scoring were performed. LNG-IUS was inserted during days 5–7 of the menstrual cycle andparticipants were followed at 3 and 6 months. Statistical analysis was performed using SPSS version 27 with a paired t-test andMcNemar test. Results: The mean age of participants was 36.17 ± 5.46 years. Heavy menstrual bleeding decreased from 50% atbaseline to 7.14% at the third month and was absent by the sixth month. Normal menstrual flow increased progressively; whilespotting and amenorrhea became more common during follow-up. Intermenstrual bleeding declined over time, indicatingstabilization of menstrual patterns. Conclusion: LNG-IUS effectively modulates menstrual patterns and reduces heavy menstrualbleeding in women with adenomyosis, supporting its role as a conservative and fertility-preserving treatment option.