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Commentary on: Gupta J, Kai J, Middleton L, et al. ECLIPSE Trial Collaborative Group. Levonorgestrel intrauterine system versus medical therapy for menorrhagia. N Engl J Med 2013;368:128–37.
Heavy menstrual bleeding (HMB), which has become the preferred terminology to describe excess menstrual bleeding or menorrhagia,1 is prevalent among reproductive age women, negatively impacts quality of life, and represents a common reason for women to seek medical care and undergo gynaecological surgery. Although numerous comparative trials have demonstrated the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) in treating HMB, in general, these studies have been of 1 year or less in duration and have included small numbers of participants.2
Gupta and colleagues randomised 571 women in the UK who reported HMB to placement of an LNG-IUS or ‘usual medical treatment’ and followed the participants for a period of over 2 years. The primary …
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