Use of the Levonorgestrel Intrauterine Device in an Adolescent with Type IV Vascular Ehlers-Danlos Syndrome and Heavy Menstrual Bleeding, a Case Report

• Published in: Journal of pediatric & adolescent gynecology Vol. 36; no. 3; pp. 331 - 333
• Main Authors: Wilde, M., Moyer, G., Huguelet, P.S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2023
• Subjects: Adolescent; Contraceptive Agents, Female - adverse effects; Ehlers-Danlos Syndrome - complications; Ehlers-Danlos Syndrome, Type IV; Female; Heavy menstrual bleeding; Humans; Intrauterine Devices, Medicated - adverse effects; Levonorgestrel - therapeutic use; Levonorgestrel intrauterine device; Menorrhagia - chemically induced; Menorrhagia - etiology; Pregnancy; Treatment Outcome; Vascular Ehlers-Danlos syndrome; LNG-IUD; Heavy menstrual bleeding; EDS; Vascular Ehlers-Danlos syndrome; Levonorgestrel intrauterine device; IUD; HMB
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2023.02.001

Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders of altered collagen synthesis. People with vascular EDS are at increased risk for vascular and hollow viscous rupture. Heavy menstrual bleeding (HMB) is common among adolescents with EDS. The levonorgestrel intrauterine device (LNG-IUD) is an effective treatment option for HMB; however, its use in patients with vascular EDS has historically been avoided due to perceived risk of uterine rupture. This is the first known case report on use of the LNG-IUD in an adolescent with vascular EDS.
A 16-year-old female with vascular EDS and HMB underwent placement of the LNG-IUD. Placement of the device was performed in the operating room under ultrasound guidance. At the 6-month follow-up, the patient reported significant improvement in bleeding and high satisfaction. No complications were identified at the time of placement or follow-up.
LNG-IUD may be a safe and effective option for menstrual management in individuals with vascular EDS.