Heavy menstrual bleeding: what works best in the long term?

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  • Levonorgestrel-releasing intrauterine system (LNG-IUS) was comparable to usual medical treatment for long-term symptom relief and surgery-free survival in patients with heavy menstrual bleeding (HMB).

Why this matters

  • There is a lack of long-term evidence regarding treatment of HMB in the primary care setting.

Study design

  • Multicentre, parallel, open-label trial.
  • Women with HMB (n=571) were randomly assigned to receive LNG-IUS or usual medical treatment (tranexamic/mefenamic acid, combined oestrogen–progestogen or progesterone alone).
  • Primary outcome: Patient reported Menorrhagia Multi-Attribute Scale (MMAS).
  • Funding: National Institute of Health Research.

Key results

  • There was a significant imp...