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A levonorgestrel releasing intrauterine system was more cost effective than was hysterectomy for menorrhagia

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 QUESTION: In women with menorrhagia, is the levonorgestrel releasing intrauterine system (IUS) more effective than hysterectomy for quality of life, psychological wellbeing, and cost outcomes?


Randomised (allocation concealed*), unblinded,* controlled trial with 12 months follow up.


5 university hospitals in Finland.


236 women who were 35–49 years of age (mean age 43 y), had menorrhagia, and were eligible for hysterectomy. Exclusion criteria were submucous fibroids, endometrial polyps, ovarian tumors or cysts (diameter >5 cm), cervical disease, urinary and bowel symptoms or pain caused by large fibroids, lack of indication for hysterectomy, history of cancer, menopause, severe depression, metrorrhagia, previous treatment failure with levonorgestrel releasing IUS, severe acne, or uterine malformation. 228 women (97%) completed the 12 month …

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  • Sources of funding: Academy of Finland; STAKES; University Hospitals, Finland. Levonorgestrel releasing IUSs provided by Leiras.

  • For correspondence: Dr R Hurskainen, STAKES, Box 220, FIN-00531 Helsinki, Finland. Fax +358 9 39672485.

  • * See glossary.