Menstrual Suppression with the Levonorgestrel Intrauterine System in Girls with Developmental Delay

Study ObjectiveTo describe the experiences of 21 girls with developmental delay accompanied by multiple other medical problems, seen over a 3-year interval, who underwent insertion of the levonorgestrel intrauterine system (LNG-IUS) for menstrual suppression.Study DesignRetrospective chart review.SettingA referral pediatric and adolescent gynecology clinic within a tertiary care medical center with referrals from community pediatricians, pediatric subspecialists including developmental and behavioral pediatricians, community gynecologists, and adolescent medicine specialists.ParticipantsAdolescents and young women with developmental delay and multiple comorbid conditions who were seen for consultation with their families requesting menstrual suppression.InterventionsParticipants were offered hormonal options, for menstrual suppression including the LNG-IUS.Main Outcome MeasuresSatisfaction with menstrual suppression among families electing the LNG-IUS.ResultsAdolescents and young women seen at CCHMC with developmental delay and multiple comorbid conditions with requests for menstrual suppression were offered hormonal options, including the LNG-IUS. Twenty-one families chose this option. Fifteen of 21 girls had previously used hormonal menstrual suppression. General anesthesia was required for 20 of 21 insertions, and 9 of 20 of these insertions were combined with other surgical procedures. There were no unsuccessful insertions or major complications. Mean duration of follow-up was 11 months, and families were satisfied with this option for menstrual suppression. There was 1 request for removal.ConclusionsLNG-IUS for menstrual suppression, in girls with developmental delay and multiple comorbid medical conditions for which amenorrhea is desirable and therapeutic, appears promising.