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Human Reproduction, Vol. 15, No. 3, 650-652, March 2000
© 2000 European Society of Human Reproduction and Embryology

Intrauterine polyps—a cause of unscheduled bleeding in women using the levonorgestrel intrauterine system: Case Report

S. Brechin1,4, S.T. Cameron1, A.M. Paterson2, A.R. Williams3 and H.O.D. Critchley1

1 Obstetrics and Gynaecology, Reproductive and Developmental Sciences, Centre for Reproductive Biology, 37 Chalmers Street, Edinburgh, EH3 9EW, 2 Obstetrics and Gynaecology, Dumfries and Galloway Royal Infirmary, Dumfries and 3 Department of Pathology, Medical School, Teviot Place, Edinburgh, EH8 9AG, UK

The levonorgestrel intrauterine releasing system is a contraceptive that has been shown to reduce menstrual blood loss dramatically. Breakthrough bleeding, however, is a relatively common occurrence as with all methods of progestogen-only contraception and this limits its acceptability for women. Amenorrhoea can be achieved in the majority of women within 12 months of insertion. Any new pattern of bleeding after amenorrhoea or a persistence of heavy bleeding may be due to co-existing intrauterine pathology such as endometrial polyps. The use of out-patient techniques such as hysteroscopy and saline infusion sonography are indicated in these instances to exclude other intrauterine pathology.

Key words: intrauterine polyps/hysteroscopy/levonorgestrel/saline infusion sonography

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