The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review

Stewart, Anthony, Cummins, Carole, Gold, Lisa, Jordan, Rachel and Phillips, Wendy 2001, The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review, BJOG: an international journal of obstetrics & gynaecology, vol. 108, no. 1, pp. 74-86.

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Title The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review
Author(s) Stewart, Anthony
Cummins, Carole
Gold, Lisa
Jordan, Rachel
Phillips, Wendy
Journal name BJOG: an international journal of obstetrics & gynaecology
Volume number 108
Issue number 1
Start page 74
End page 86
Publisher Wiley-Blackwell Publishing Ltd.
Place of publication Bognor Regis, England
Publication date 2001-01
ISSN 0140-7686
1471-0528
Summary Objective: To determine whether the levonorgestrel-releasing intrauterine device (LNG-IUS), licensed at present for contraceptive use, may reduce menstrual blood loss with few side effects. If effective, surgery could be avoided with consequent resource savings. Methods: A systematic review addressing the effectiveness and cost effectiveness of the LNG-IUS for menorrhagia was undertaken. Results: Five controlled trials and five case series were found which measured menstrual blood loss. Nine studies recorded statistically significant average menstrual blood loss reductions with LNG-IUS (range 74%–97%). Another showed reduction in menstrual disturbance score. The LNG-IUS was more effective than tranexamic acid, but slightly less effective than endometrial resection at reducing menstrual blood loss. In one study, 64% of women cancelled surgery at six months, compared with 14% of control group women. In another, 82% were taken off surgical waiting lists at one year. No cost effectiveness studies were found. Discussion: Small studies of moderate quality indicate the LNG-IUS is an effective treatment for menorrhagia. Costs may be less than for tranexamic acid in primary and secondary care. Although its use may reduce surgical waiting lists, cost effectiveness assessment requires longer follow up. Conclusion: Effectiveness and cost effectiveness relative to other treatments and the effect on surgical waiting lists can only be established in larger trials measuring patient-centred outcomes in women with menorrhagia.
Language eng
Field of Research 111402 Obstetrics and Gynaecology
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2001, British Journal of Obstetrics and Gynaecology
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009125

Document type: Journal Article
Collection: School of Health and Social Development
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