Documento orientador para a gestão no uso do sistema intrauterino libertador de levonorgestrel para o tratamento do sangramento uterino anormal

Abstract

Introduction. Abnormal uterine bleeding (SUA) is a syndrome characterized by a change in a woman's menstrual pattern that negatively influences her quality of life. The causes range from uterine structural pathologies (polyps, fibroids, adenomyosis, malignancies) to functional disorders (coagulation disorders, ovulation), with about 20% of cases without a defined factor. The treatment has the function of making menstruation tolerable and can be performed by oral medication, injection, implant, intrauterine device or, in case of failure of the above, hysterectomy or endometrial ablation. Levonorgestrel-releasing intrauterine system - SIU-LNG emerges as a non-invasive, cost-effective treatment with a positive impact on quality of life. Objective. To create a document relied on the actual international literature that could guide the use of LNG-IUS on the public health care. Methods. To evaluate it, a literature review was performed in the PUBMED, Cochrane and Lilacs databases, from articles published until June 2019 focusing on SIU-LNG as the one of the interventions in the treatment of SUA. Results. It was observed that this is a therapeutic option even considered as the first line of treatment in some countries, precisely because of its cost-effectiveness, reversibility (for women without defined offspring) and good control of SUA. Developed product. Consists in an analyze of the actual literature showing the advantages of LNG-IUS use as a cost-effective treatment for the heavy menstrual bleeding. Conclusion. In Brazil, this drug is not available in the public health system, and no longer benefits a portion of women eligible for its use. The evidence presented in this paper is expected to help change this reality and significantly reduce the number of women who are often exposed to unnecessary surgical treatment.