LNG-IUS better than medical therapy for menorrhagia
A randomized UK study of menorrhagia shows that the levonorgestrel intrauterine system (LNG-IUS) is more effective than standard medical treatment in reducing the adverse effect of the menstrual problem on women’s quality of life.
The multicenter ECLIPSE (Effectiveness and Cost-Effectiveness of Levonorgestrel-Containing Intrauterine System in Primary Care against Standard Treatment for Menorrhagia) trial enrolled 571 women aged 25 to 50 years. All the participants presented to primary care physicians with complaints of menorrhagia during at least 3 consecutive menstrual cycles. Randomization was to the LNG-IUS or standard therapy for menorrhagia (tranexamic acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone).
The goal of the research was to assess, over a 2-year period, patient-reported scores on the Menorrhagia Multi-Attribute Scale (MMAS), which measures the effect of menorrhagia on practical difficulties, social life, psychological health, physical health, work and daily routine, and family life and relationships. MMAS scores were assessed at 6, 12, and 24 months on a scale from 0 (severely affected) to 100 (not affected). The study had 90% power (P<0.05) to detect 0.3 SD differences in primary outcome at any given time.