Study of ovarian function in amenorrheic users of Mirena®

Study of ovarian function in amenorrheic users of Mirena®

I.C. Barbosa, H. Maia Jr, A. Botto, R. Lopes, A.C.V. Lopes

Department of Gynecology, Obstetrics and Human Reproduction, Federal

University of Bahia, Salvador, Bahia, Brazil

Objectives: The objective of this study was to evaluate changes in

ovarian activity and in cervical mucus in amenorrheic users of Mirena®.

Material & Methods: Twenty amenorrheic patients, who had been

using Mirena® for three years, were studied during 60 days. Ultrasonography,

blood sampling for hormone measurement of estradiol, progesterone and LH, as

well as cervical mucus collection, were carried out twice weekly during 60 days.

Results: Fifty-two percent of women presented progesterone peaks

>15.0 nmol/l, and follicular activity as assessed by vaginal sonography. Of

these women, 25% presented persistent follicular cysts mm (mean maximum

diameter=35.4+1.7 mm). These follicular cysts disappeared spontaneously

within a maximum of 55 days. Twenty-seven percent of women presented follicular

development and normal follicular rupture with progesterone levels >15.0 nmol/l.

Forty-eight percent of women presented no follicular development and no luteinic

activity according to progesterone levels and vaginal sonography. All twenty

women had sparse, viscous cervical mucus and the material collected was

insufficient for analysis.

Conclusions: These results confirm previous findings that the most

important mechanism of action of Mirena® is the local effect it exerts on the

endometrium and on cervical mucus. This study also confirms that the majority of

patients in amenorrhea have ovulatory cycles. The physical and chemical changes

in the characteristics of the cervical mucus of amenorrheic patients result in

the high efficacy rate of Mirena® as a contraceptive method.

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