RESUMEN
Menorrhgia is one of the commonest gynecological problems, yet medical treatment has been disappointing. Levonorgestrel released from an intrauterine system suppresses endometrial growth and causes marked reduction of menstrual loss menorrhagic women. To study the mechanism by which Levonorgestrel releasing intrauterine system, [Mirena, Schering], can control menorrthagia by evaluating its effect on blood flow in the uterine and subendometrial region, and endometrial thickness using color Doppler. Setting: in Alyamamah Maternity Hospital and Hammadi specialized Hospital. Design: prospective observational study. Patients and thirty two patients were included in this study complaining of menorrhagia. Levonorgesttrel releasing intrauterine system, [Mirena, Schering], was inserted. Menstrual blood loss was measured using the pictorial blood loss assessment chart, pulsatility index of uterine artery, subendometrial blood flow and endometrial thickness were measured before and six months after insertion. Levonorgestrel releasing intrauterine system reduced menstrual blood loss. There was no significant difference in pulsatility index of uterine artery before and after insertion, but, there was highly significant reduction in the blood flow in the subendomentrial region. Also, there was highly significant reduction in the endometrial thickness. Through its local effect on endometrium, Levonorgestrel releasing intrauterine device a good option for treatment of menorrhagia so, it is advisable before resorting to any invasive surgical maneuver