Abstract
Objective: To compare endometrial ablation and levonorgestrel-IUS for treatment of refractory
reccurrent hypermenorrhea. Study design: 30 patients with refractory recurrent hypermenorrhea were included in a prospective
controlled comparative study. A transcervical Roller-Ball ablation was carried out
in 15 patients after a 2-months GnRH analog pretreatment. A levonorgestrel IUD (MIRENAR, Schering AG Berlin, Germany) was inserted in 15 patients for the treatment of hypermenorrhea.
In a follow-up of the bleeding behavior over 12–24 months a reduction of bleeding
was achieved in 14 of 15 patients after Roller-Ball ablation and in 11 of 15 patients
after levonorgestrel IUD insertion. The amenorrhea rates are roughly the same in both
groups. Side effects of levonorgestrel IUS were rare and mostly temporary. Conclusions: The insertion of a levonorgestrel IUD for the local hormonal treatment of recurrent
hypermenorrhea refractory to oral treatment can be tried before endometrial ablation.
The MIRENAR device is particularly advantageous for younger patients who might wish to have more
children. The levonorgestrel IUD treatment can replace approx. 75% of endometrial
ablations.
Keywords
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References
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Article info
Publication history
Accepted:
August 16,
1999
Received in revised form:
February 2,
1999
Received:
November 2,
1998
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
