Levonorgestrel-IUS Beats Usual Care for Menorrhagia
(HealthDay News) – Compared with standard medical therapy, women with menorrhagia experience more effective, sustained physical and quality-of-life benefits from treatment with a levonorgestrel-releasing intrauterine system (IUS), according to a study published in the Jan. 10 issue of the New England Journal of Medicine.
Janesh Gupta, MD, of the University of Birmingham in the United Kingdom, and colleagues conducted a randomized study involving 571 women with menorrhagia who received either the levonorgestrel-releasing IUS or usual treatment, which consisted of tranexamic acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone. Patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) was evaluated over a two-year period.
The researchers found that in both groups there was a significant improvement in MMAS scores from baseline–6 months, and these improvements were maintained over a two-year period and were significantly greater in the levonorgestrel-IUS group. The improvement with the levonorgestrel-IUS treatment was significantly greater in all domains of the MMAS and in seven of eight of the quality-of-life domains. At two years, 64% of women were still using the levonorgestrel-IUS system, compared with only 38% who were still receiving standard medical therapy.
"Our study showed that both the levonorgestrel-IUS and usual medical treatments reduced the adverse effect of menorrhagia on women's lives over the course of two years, but the levonorgestrel-IUS was the more effective first choice, as assessed by the impact of bleeding on the women's quality of life," the authors write.
One author disclosed financial ties to the industry related to the study topic, and has provided expert testimony in cases related to the study topic.