- 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.
- 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.
- There was a significant improvement in MMAS scores from the baseline in the LNG-IUS and usual treatment groups (mean increase, 44.9 and 43.4 points, respectively; P<.001).
- There was no significant difference in the MMAS scores amongst both groups (3.9 points; P=.09).
- 5-y surgery-free survival rates were high in both groups (80% and 77%; P=.6).
- Individual drugs were not compared with LNG-IUS.
- Cessation or change in menstrual periods, or cessation of therapy could have affected results.