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Randomised controlled trial
The levonorgestrel intrauterine system: effective non-surgical treatment for heavy menstrual bleeding
  1. Andrew M Kaunitz
  1. Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA
  1. Correspondence to: Professor Andrew M Kaunitz
    Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, 653-1 W 8th Street, Jacksonville, FL 32209, USA; andrew.kaunitz{at}jax.ufl.edu

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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.

Context

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

Methods

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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