Levonorgestrel-Releasing Intrauterine System Lightens Heavy Menstrual Bleeding

Heavy menstrual bleeding, defined as blood loss ≥80 mL per cycle, is a common reason for hysterectomy. Virtually all insurance companies require a trial of medical therapy before approving surgical management of this condition — but is medical treatment effective? In a manufacturer-supported, multicenter, randomized, controlled 6-month study involving 162 women (mean age, 39) with objectively documented heavy menstrual bleeding, the effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) was compared with that of oral medroxyprogesterone acetate (MPA; 10 mg daily for 10 days beginning on cycle day 16).

Nearly 90% of participants completed the trial. Fewer than one third (30%) of women who received MPA had reductions in bl…