Surgery versus medical therapy for heavy menstrual bleeding

Abstract

Surgery reduces menstrual bleeding at one year more than medical treatments, but LNG-IUS appears equally beneficial in improving quality of life and may control bleeding as effectively as conservative surgery over the long term. Oral medication suits a minority of women long term.

The levonorgestrel intrauterine system (Mirena®) for treatment of idiopathic menorrhagia. Assessment of quality of life and satisfaction

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The levonorgestrel intrauterine system (Mirena®) for treatment of idiopathic menorrhagia. Assessment of quality of life and satisfaction

“……”

Intraoperative cervical treatment does not affect the prevalence of vaginal bleeding 1 year postoperatively after subtotal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery

“…More than 90% of women report a high satisfaction rate and improvements of quality of life several years following hysterectomy, irrespective of surgical approach or technique . This study supports the notion of a high satisfaction rate.…”

Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care

“…At 2 years post-randomisation, surgical interventions were low at about 10% in both medical treatment groups,12 and this has approximately doubled to 20% in both groups at 5 years. This is still much lower than the 58% surgical intervention rate at 2 years identified in an earlier Cochrane Review of trials comparing oral medical therapy with surgical interventions for HMB, although these were in secondary care settings 27. The relatively low surgical intervention rates in the current trial may also possibly be explained by exclusion of women with enlarged uteri or known conditions such as fibroids that were deemed unsuitable for treatment in a community setting.…”

The levonorgestrel intrauterine system (Mirena®) for treatment of idiopathic menorrhagia. Assessment of quality of life and satisfaction

“……”

Intraoperative cervical treatment does not affect the prevalence of vaginal bleeding 1 year postoperatively after subtotal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery

“…More than 90% of women report a high satisfaction rate and improvements of quality of life several years following hysterectomy, irrespective of surgical approach or technique . This study supports the notion of a high satisfaction rate.…”

Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care

“…At 2 years post-randomisation, surgical interventions were low at about 10% in both medical treatment groups,12 and this has approximately doubled to 20% in both groups at 5 years. This is still much lower than the 58% surgical intervention rate at 2 years identified in an earlier Cochrane Review of trials comparing oral medical therapy with surgical interventions for HMB, although these were in secondary care settings 27. The relatively low surgical intervention rates in the current trial may also possibly be explained by exclusion of women with enlarged uteri or known conditions such as fibroids that were deemed unsuitable for treatment in a community setting.…”

The levonorgestrel intrauterine system (Mirena®) for treatment of idiopathic menorrhagia. Assessment of quality of life and satisfaction

“……”

Intraoperative cervical treatment does not affect the prevalence of vaginal bleeding 1 year postoperatively after subtotal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery

“…More than 90% of women report a high satisfaction rate and improvements of quality of life several years following hysterectomy, irrespective of surgical approach or technique . This study supports the notion of a high satisfaction rate.…”

Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care

“…At 2 years post-randomisation, surgical interventions were low at about 10% in both medical treatment groups,12 and this has approximately doubled to 20% in both groups at 5 years. This is still much lower than the 58% surgical intervention rate at 2 years identified in an earlier Cochrane Review of trials comparing oral medical therapy with surgical interventions for HMB, although these were in secondary care settings 27. The relatively low surgical intervention rates in the current trial may also possibly be explained by exclusion of women with enlarged uteri or known conditions such as fibroids that were deemed unsuitable for treatment in a community setting.…”