IUD vs. hysterectomy for menorrhagia

The levonorgestrel-releasing intrauterine system (LNG-IUS) can provide a cost-effective alternative to hysterectomy for women with menorrhagia, according to a recent controlled trial reported in JAMA.

Finnish researchers randomized 236 women with a mean age of 43 years and menorrhagia to treatment with either the LNG-IUS or hysterectomy. After 5 years of follow-up, the two groups did not differ substantially in either health-related quality of life or psychosocial well-being. Satisfaction with treatment was similar in both groups. While 42% of the LNG-IUS group eventually received hysterectomy, after 5 years direct and indirect costs in the LNG-IUS group remained about 40% lower than for the hysterectomy group.

Hurskainen R, Teperi J, Rissanen P, et al. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up. JAMA. 2004;291:1456-1463.