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Review: surgery is more effective than medical treatment for heavy menstrual bleeding but quality of life results are similar

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 Q In women with heavy menstrual bleeding, what are the relative efficacy, safety, and acceptability of surgical and medical treatments?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Gynaecology ★★★★★★☆ Endocrine ★★★★★★☆


Embedded ImageData sources:

Cochrane Central Register of Controlled Trials (issue 3, 2005), Cochrane Menstrual Disorders and Subfertility Group trial register, Medline, CINAHL, EMBASE/Excerpta Medica, Current Contents, Biological Abstracts, PsycINFO (September 2005), relevant journals, conference abstracts, reference lists, pharmaceutical companies, and experts.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared surgical treatment (hysterectomy, resection, or ablation) with medical treatment (oral drugs or the levonorgestrel intrauterine system [LNG-IUS]) for heavy menstrual bleeding in women of reproductive age (mean age 41–44 y). 8 RCTs (n = 821) met the selection criteria. Excluded were studies involving postmenopausal or intermenstrual bleeding; irregular …

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  • For correspondence: MsJ Marjoribanks, University of Auckland, Auckland, New Zealand. j.marjoribanks{at}

  • Source of funding: no external funding.