Long-Term Treatment of Menorrhagia With Levonorgestrel Intrauterine System Versus Endometrial Resection

Abstract

Both treatments efficiently reduced menstrual bleeding. The high continuation rate suggests that the levonorgestrel intrauterine system is comparable with transcervical resection of the endometrium.

Continuation rates and satisfaction with the Levonorgestrel Intrauterine System. Letter to the Editor in response to an article published in volume 31, by Dr. Ewies

“…Ewies does not cite other studies that have shown higher continuation rates in the treatment of HMB [1][2][3][4]. We suggest that it would have been appropriate to compare the continuation rates of the LNG-IUS with a comparator treatment.…”

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial

“…An updated review identified seven further randomised trials, [38][39][40][41][42][43][44] involving only 718 women in total, which compared the LNG-IUS with non-hormonal and hormonal treatments. In an industry-sponsored review, 45 reduction in menstrual blood loss was achieved in only 230 women, from five studies, 33,38,43,44,46 in which the LNG-IUS was administered.…”

“…In an industry-sponsored review, 45 reduction in menstrual blood loss was achieved in only 230 women, from five studies, 33,38,43,44,46 in which the LNG-IUS was administered. Reported median blood loss had decreased by 85% by 3 months, and had further decreased, by a total of 94%, by 12 months, remaining constant thereafter to 5 years.…”

“…50 No difference in the rates of amenorrhoea or satisfaction rates were seen compared with endometrial ablation, although menstrual blood loss was reduced to a greater extent with ablation. 29,48 In a subsequent Cochrane review of medical versus surgical treatments for HMB, 51 an additional six trials, four 49,[52][53][54] comparing the LNG-IUS with thermal balloon ablation, one 55 comparing the LNG-IUS with hysterectomy and two 38,56 comparing the LNG-IUS with first-generation ablation, were included. There was no statistically significant difference in satisfaction rates up to 2 years or in most domains of the Short Form questionnaire-36 items (SF-36) measure of QoL.…”

Role of levonorgestrel releasing intra-uterine system in the treatment of menorrhagia due to dysfunctional uterine bleeding and fibroid uterus

“…In recent years LNG-IUS has been increasingly advocated as an alternative to hysterectomy for menorrhagia. [6][7][8][9][10] This intrauterine system consists of a T-shaped polyethylene frame (32 mm × 32 mm) with a levonorgestrel (LNG)-containing reservoir around its vertical stem. It contains a 1:1 mixture of 52 mg of LNG and polydimethylsiloxane as the carrier polymer.…”