2025, Vol. 7, Issue 3, Part C

Background: Heavy menstrual bleeding (HMB) has a considerable impact on women's quality of life and healthcare delivery systems around the world. Hormonal intrauterine devices (IUDs) have been shown to be effective non-contraceptive methods for HMB management, but they are underutilized in Iraq.

Objective: To assess the effectiveness and acceptability of levonorgestrel-releasing intrauterine systems (LNG-IUS) for HMB management in women attending a private gynecology clinic in Baghdad, Iraq.

Methods: A prospective observational study was conducted at a Private Gynecology Clinic in Baghdad from January 2023 to December 2024. Women aged 18 to 50 years who had been diagnosed with HMB were offered LNG-IUS insertion. Primary outcomes for this study included changes in menstrual blood loss, health-related quality of life (HRQoL), and patient satisfaction. Secondary outcomes included hemoglobin levels, pain scores, and continuation rates.

Results: A total of 248 women participated in the study, of which 186 women completed the 12-month follow-up. The mean menstrual blood loss decreased from 127.3 (±45.2) ml to 23.6 (±18.7) ml (p<0.001). Hemoglobin levels increased significantly from 9.2 (±1.8) g/dL to 12.1 (±1.4) g/dL (p<0.001). Improvements were seen in HRQoL scores across all domains. The overall satisfaction rate was 89.2%, and the continuation rate at 12 months was 92.7%.

Conclusions: LNG-IUS is an effective method in reducing HMB and improving the HRQoL of Iraqi women with HMB and should be considered a first-line treatment in comparable healthcare settings.