Levonorgestrel-releasing intrauterine system effective treatment for heavy menses

January 01, 0001

Levonorgestrel-releasing intrauterine system effective treatment for heavy menses

This study by authors from multiple countries compared the efficacy and safety of the levonorgestrel-releasing intrauterine system and oral medroxyprogesterone acetate in the treatment of idiopathic heavy menstrual bleeding. Women aged 18 years or older with menstrual blood loss 80 mL or more per cycle were randomly assigned to six cycles of treatment with either levonorgestrel-releasing intrauterine system or oral medroxyprogesterone acetate (10 mg daily for 10 days beginning on day 16 of each cycle). The primary efficacy variables were the absolute change in menstrual blood loss from baseline to end of study and the proportion of women with successful treatment (defined as menstrual blood loss less than 80 mL and a 50% or greater reduction in menstrual blood loss from baseline).

They found: "Of 807 women screened, 165 were randomly assigned to treatment (levonorgestrel-releasing intrauterine system n=82, oral medroxyprogesterone acetate n=83). At the end of the study, the absolute reduction in median menstrual blood loss was significantly greater in the levonorgestrel-releasing intrauterine system group (-128.8 mL, range -393.6 to +1242.2 mL) than in the medroxyprogesterone acetate arm (-17.8 mL, range - 271.5 to +78.6 mL), and the proportion of women with successful treatment was significantly higher for the levonorgestrel-releasing intrauterine system (84.8%) than for medroxyprogesterone acetate (22.2%)."

The authors concluded: "In women with idiopathic heavy menstrual bleeding, the levonorgestrel-releasing intrauterine system reduces menstrual blood loss more effectively and has a higher likelihood of treatment success than oral medroxyprogesterone acetate."

Levonorgestrel-releasing intrauterine system is a good choice for women with heavy menses and who also want a contraceptive method.

For the full abstract, click here.

Obstet Gynecol 116(3):625-632, September 2010
© 2010 to the American College of Obstetricians and Gynecologists
Levonorgestrel-Releasing Intrauterine System or Medroxyprogesterone for Heavy Menstrual Bleeding: A Randomized Controlled Trial. Andrew M. Kaunitz, Francois Bissonnette, Ilza Monteiro, Eeva Lukkari- Lax, Christoph Muysers, Jeffrey T. Jensen. Correspondence to Dr. Kaunitz: [email protected]

Category: X. Female Genital System, Breast. Keywords: levonorgestrel-releasing intrauterine system, medroxyprogesterone, menorrhagia, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 12 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.