LNG-IUS vs. Combination Oral Contraceptives for Heavy Menstrual Bleeding

Both the levonorgestrel-releasing intrauterine system (LNG-IUS) and combination oral contraceptives (COCs) are effective for treating heavy menstrual bleeding, but head-to-head studies have been few. In a randomized trial supported by the manufacturer of the LNG-IUS, researchers compared efficacy of the LNG-IUS with that of a COC (30 µg of ethinyl estradiol plus 150 µg of levonorgestrel) in 112 women (mean age, 39) with self-described heavy menstrual bleeding.

During 12-month follow-up, 6 women in the LNG-IUS group and 18 in the COC group experienced treatment failures (i.e., LNG-IUS expulsion or removal, initiation of alternative medical therapy, or need for surgery). In the LNG-IUS group, mean monthly menstrual blood loss (MBL) — measured …