Key Points

• The 52mg LNG-IUS (levonorgestrel-releasing intrauterine systems) developed for contraception, have shown value in the treatment of AUB-A, E, and C and have been evaluated for AUB-L
• As with other gonadal steroids, the goal of using the LNG-IUS 52 is for the treatment of AUB-L; there is  no known benefit for fertility or volumetric reduction
• The available data suggset that when leiomyomas are sub mucous, the spontaneous expulsion rate is higher.

The LNG-IUD is a T-shaped device with a levonorgestrel reservoir. In addition to its contraceptive efficacy, it has also been shown to reduce the duration and amount of menstrual bleeding, with minimal side effects due to its local effect (13). There is evidence indicating its effect in reducing menstrual bleeding without altering the size of the fibroid, in addition to an improvement in hemoglobin levels (14,15).   

Expulsion of the LNG-IUD is uncommon, risk factors have been identified such as heavy menstrual bleeding, overweight, obesity under 24 years of age, parity of four or more . Patients should be counseled in this regard (16).