Treatment of menorrhagia with the levonorgestrel intrauterine system versus endometrial resection

Abstract

Objective: Treatment of menorrhagia with levonorgestrel intrauterine system (LNG IUS) and transcervical resection.

Design: An open, therapeutic, randomized study.

Setting: Central county hospital specializing in hysteroscopy.

Patient(s): Two parallel groups of 30 subjects each.

Intervention(s): Thirty patients had a LNG IUS inserted within the first 7 days of menses; 29 patients underwent endometrial resection.

Main outcome measure(s): A 12-month follow-up of menstrual blood loss and adverse events were evaluated.

Result(s): LNG IUS group: 13 patients reported one or more pelvic adverse events, bleeding disorders (n = 6), abdominal pain (n = 4), breast tenderness (n = 3), headache, acne (n = 2), and mood changes (n = 1). Six patients discontinued treatment because of irregular bleeding (n = 3), pain (n = 2), and acne (n = 1). In both groups, general feeling of genital health increased with Visual Analogue Scale score. Nine patients reported adverse events. This included pelvic pain indicating inflammation (n = 4), bleeding (n = 3), vaginitis (n = 1), and ulceration (n = 1). Treatment success at 12 months was achieved in 20 (67%) of the 30 patients in the LNG IUS group and in 26 (90%) of the 29 patients in the transcervical resection group. Adverse events were more often reported in the LNG IUS group.

Conclusion(s): Both treatments effectively reduced the menstrual blood loss. Furthermore, the LNG IUS treatment is reversible and has no operative hazards.