Clinical Outcomes and Costs With the Levonorgestrel-Releasing Intrauterine System or Hysterectomy for Treatment of Menorrhagia: Randomized Trial 5-Year Follow-up.

About one third of women report heavy menstrual bleeding at some time in their lives. Menorrhagia is the presenting symptom among the majority of women who undergo hysterectomy. An alternative to surgery is the levonorgestrel-releasing intrauterine system (LNG-IUS) (Schering Co, Turku, Finland). The LNG-IUS system releases 20 μg of levonorgestrel every 24 hours over 5 years. The estimated number of current LNG-IUS users worldwide is more than 4 million, in approximately 100 countries. A menorrhagia treatment trial was conducted between 1994-2002 and the clinical findings, quality-of-life outcomes, and costs after 5 years of follow-up are reported here. Overall, 236 women (aged 35-49 yrs) who were menstruating, had completed their desired family size, and were eligible for both treatments were randomized for the LNG-IUS (n=119) or hysterectomy (n=117). In the treatment of menorrhagia, the health-related quality-of-life outcomes associated with the LNG-IUS and hysterectomy were similar. Although 42% of the women assigned to the LNG-IUS group subsequently underwent hysterectomy, the overall direct and indirect costs after 5 years were still approximately 40% lower in the LNG-IUS group. In general, women were equally satisfied with the LNG-IUS and with hysterectomy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)