Avaliação da qualidade de vida após inserção do sistema intrauterino liberador de levonogestrel em mulheres com asma moderada-grave e hipertensão pulmonar: estudo prospectivo

Abstract

The use of the Levonorgestrel-Releasing Intrauterine System (LNG-IUS) is a safe and effective method of non-permanent contraception that can be used by most women with comorbidities. A prospective cohort study was conducted to evaluate the use of the LNG-IUS in a population of women with lung disease (moderate-severe asthma and pulmonary hypertension), aged 18-55 years, with indications for its use (contraception, cessation of menstruation, control of abnormal uterine bleeding, dysmenorrhea, and others). Fourteen patients who wished to start using the LNG-IUS were evaluated. The primary objective was to assess the impact of device use on quality of life, as evaluated by the Medical Outcomes Short-Form Health Survey (SF-36) quality of life questionnaire. Secondary objectives were to verify the method adherence rate for six months, ease of insertion, and occurrence of complications associated with the procedure; menstrual pattern after insertion; occurrence of dysmenorrhea; reasons for discontinuation of the method (bleeding, abdominal pain, acne, mood swings, decreased libido, others). During the study, 14 SIU-LNGs were inserted, six (43%) in participants with moderate-severe asthma and eight (57%) in participants with HP. The mean age of the participants was 37 years (19-54). The main reason for choosing the method was contraception (79%), followed by bleeding control (21%). There were no difficulties in inserting the SIU-LNG, although two participants with asthma (14%) experienced vasovagal reflex during the procedure. The median physical and mental component scores for asthmatic women were 39,1 and 47,2 at the initial visit and 55,0 and 43,0 six months after SIU-LNG insertion, respectively. For women with pulmonary hypertension, these scores were 54,4 and 44,5 for the first visit and 45,6 and 50,1 after six months. The p values for all physical and mental components were not statistically significant (p>0.05). Despite this, regarding the use of the method, in our study, 92% of patients reported satisfaction with the method. We did not observe any significant side effects in either group. The use of SIU-LNG showed a reduction in menstrual flow in women with a previous history of metrorrhagia. In addition, there was a reduction in previous symptoms of headache.