LONDON (Reuters Health) Mar 20 – Levonorgestrel intrauterine systems offer an effective and safe alternative to surgery in women suffering from menorrhagia, according to a long-term study published in the British Journal of Obstetrics and Gynaecology for March.
The findings are important because of the significant morbidity and mortality associated with hysterectomy and endometrial ablation, and because treatment of menorrhagia represents a major burden to the health service, researchers said.
Peter Bowen-Simpkins, of the department of obstetrics and gynaecology at Singleton Hospital, Swansea, and colleagues recruited 50 women in 1995-96 who were waiting for surgery after failing to respond to a combination of antiprostaglandins and antifibrinolytics.
The women were offered and accepted Schering's levonorgestrel intrauterine system, Mirena, which was originally developed as a contraceptive but has also proved useful in reducing menstrual blood loss in the short term.
In this long term follow-up study, the women were asked about their bleeding patterns 4 to 5 years after the device was inserted.
Of the 50 women recruited, questionnaires were returned by 36 of whom 23 were still using the device. Eight were amenorrhoeic, 13 described occasional bleeding and two had regular cyclical bleeding.
The researchers said that the most important observation was that only 26% of the women eventually had surgical treatment, despite the fact that half the women did not continue using the device.
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