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Surgery or IUD for Heavy Periods

A systematic review of studies has revealed that surgery is a more effective effective option than oral or intrauterine medication for women experiencing heavy periods in reducing volume of bleeding at one year. //

However, on subjective measures of effectiveness — satisfaction and improved quality of life — a hormone-releasing intrauterine device (IUD) is as effective as surgery, the review found.

“Satisfaction with treatment is probably more meaningful than estimates of blood loss. While conservative surgery reduced blood loss more than the IUD, the two treatments appeared about equal in terms of patient satisfaction,” said review co-author Jane Marjoribanks, at the University of Auckland in New Zealand.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

The reviewers identified eight randomized controlled trials that compared either hysterectomy or conservative surgery with medical therapy using either oral drugs or the hormone-releasing IUD. The studies enrolled a total of 821 women.

Heavy menstrual bleeding affects about one in five women of reproductive age and is the most common cause of anemia in premenopausal women. Medical treatments include oral drugs and a hormone-releasing IUD to decrease blood loss. Surgical options range from conservative procedures that destroy the lining of the uterus to hysterectomy, which removes the uterus entirely. While hysterectomy is the only treatment that is completely effective, it also carries the highest risk.

In the two studies that compared surgery and oral medications, surgery was more effective in controlling bleeding and other symptoms and improving women’s quality o
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