Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding

Lethaby, Anne; Cooke, Inez; Rees, Margaret

doi:10.1002/14651858.cd002126.pub2

Cited by 180 publications

(154 citation statements)

References 27 publications

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“…Similar to the results of our study, Preston et al [14] found that QOL measures, flooding, leakage and sex life were significantly improved in the tranexamic acid group compared with the oral progesterone group. It has also been reported that LNG-IUS treatment resulted in QOL measures comparable to that of hysterectomy [32]. In an open randomized study, two thirds of women with menorrhagia who were on the list for surgery and who were given LNG-IUS treatment cancelled their decision to undergo hysterectomy after 6 months due to high satisfaction with the LNG-IUS treatment [28].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Kiseli

Kayıkçıoğlu

Evliyaoğlu

et al. 2016

Gynecol Obstet Invest

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Background: Our aim was to compare the therapeutic efficacies of norethisterone acid (NETA), tranexamic acid and levonorgestrel-releasing intrauterine system (LNG-IUS) in treating idiopathic heavy menstrual bleeding (HMB). Methods: Women with heavy uterine bleeding were randomized to receive NETA, tranexamic acid or LNG-IUS for 6 months. The primary outcome was a decrease in menstrual bleeding as assessed by pictorial blood loss assessment charts and hematological parameters analyzed at the 1st, 3rd and 6th months. Health-related quality of life (QOL) variables were also recorded and analyzed. Results: Twenty-eight patients were enrolled in each treatment group, but the results of only 62 were evaluated. NETA, tranexamic acid, and LNG-IUS reduced menstrual blood loss (MBL) by 53.1, 60.8, and 85.8%, respectively, at the 6th month. LNG-IUS was more effective than NETA and tranexamic acid in decreasing MBL. LNG-IUS was also more efficient than tranexamic acid in correcting anemia related to menorrhagia. Satisfaction rates were comparable among the NETA (70%), tranexamic acid (63%) and LNG-IUS (77%) groups. QOL in physical aspects increased significantly in the tranexamic acid and LNG-IUS groups. Conclusion: The positive effect of LNG-IUS on QOL parameters, as well as its high efficacy, makes it a first-line option for HMB.

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Section: Discussionmentioning

confidence: 99%

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Kiseli

Kayıkçıoğlu

Evliyaoğlu

et al. 2016

Gynecol Obstet Invest

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“…B. in Form von Norethistheron über 21 Tage) effektiver und werden von einer Vielzahl der betroffenen Patientinnen bevorzugt. Auch wenn die Verwendung eines LNG-IUS im Vergleich zur Endometriumablation den menstruationsbedingten Blutverlust weniger effektiv zu reduzieren vermag, wird es von den betroffenen Frauen in der Regel besser akzeptiert und führt zu einer besseren Lebensqualität [19]. In Zeiten, in denen die Kosten einer Therapie zunehmende Bedeutung in der klinischen Entscheidungsfindung erlangt haben, ist die 7 Kosteneffektivität ein weiterer Entscheidungsparameter geworden.…”

Section: Levonorgestrel-haltige Intrauterinsystemeunclassified

Dysfunktionelle uterine Blutung

Liedtke

Kiesel

2006

Gynäkologische Endokrinologie

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Die dysfunktionelle uterine Blutung (DUB) ist definiert als eine überstarke Menstruationsblutung ohne erkennbares pathomorphologisches Korrelat und stellt demzufolge eine Ausschlussdiagnose dar. Eine DUB bei anovulatorischem Zyklus ist eine Folge systemischer endokriner oder pharmakologischer Veränderungen. Die ovulatorische DUB stellt hingegen eine Störung der lokalen Hä-mostase dar. Die klinische Diagnostik stützt sich auf Anamnese, körperliche und gynäkologische Untersuchung, Laboranalysen und histopathologische Untersuchung. Ausgeschlossen werden sollten sowohl systemische Ursachen (z. B. Blutgerinnungsstörungen) als auch lokale Ursachen (z. B. genitale Neoplasien oder Infektionen). Derzeit steht eine Vielzahl von medikamentös-konservativen Behandlungsformen zur Verfügung, die sowohl hormonell als auch nichthormonell erfolgen können. Sollten konservative Maßnahmen versagen, kommen verschiedene operative Techniken wie die Endometriumablation oder letztlich die Hysterektomie zum Einsatz. SchlüsselwörterDysfunktionelle uterine Blutung · Endometrielle Ablation · Menorrhagie · Ovulatorisch · Anovulatorisch Dysfunctional uterine bleeding Abstract Dysfunctional uterine bleeding (DUB) is defined as heavy menstrual bleeding without a recognizable pathomorphologic correlate and is hence a diagnosis of exclusion. Anovulatory DUB is a systemic disorder which may occur secondary to endocrine or hematologic mechanisms. Ovulatory DUB is regarded as a consequence of defects in local endometrial hemostasis. The clinical diagnostics comprise patient history, physical and gynecologic examination, and laboratory and histologic evaluation. Exclusion of both systemic causes such as hemostatic disturbances and local diseases (i.e., genital neoplasia or genital infection) is essential. A variety of medical therapies are currently available including both hormonal and nonhormonal approaches. In case of persistent complaints, the available surgical techniques range from less invasive endometrial ablation to more radical approaches such as hysterectomy. KeywordsDysfunctional uterine bleeding · Endometrial ablation · Menorrhagia · Ovulatory · Anovulatory CME Weiterbildung · Zertifizierte Fortbildung Redaktion L. Kiesel, Münster M. Ludwig, Hamburg CME.springer.de -Zertifizierte Fortbildung für Kliniker und niedergelassene Ärzte

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“…25 The proportion of women who are amenorrhoeic a year following insertion has been reported at around 12%. 26,27 Effectiveness of the levonorgestrel-releasing intrauterine system for heavy menstrual bleeding Clinical effectiveness of the levonorgestrel-releasing intrauterine system compared with medical treatments…”

Section: Introductionmentioning

confidence: 99%

“…In comparing the LNG-IUS with non-surgical options, NICE referred to the Cochrane review, 27 which cited three small randomised trials comparing the LNG-IUS with norethisterone, 24,32 mefenamic acid 32,33 or danazol 32 (Danol ® , Sanofi-aventis), although the trial reported by Cameron et al 32 used a now discontinued formulation of the LNG-IUS. From this review, the odds ratio for amenorrhoea (> 3 months) was 8.67 [95% confidence interval (CI) 1.52 to 49.35] in favour of the LNG-IUS.…”

Section: Introductionmentioning

confidence: 99%

“…11,21,27,35 NSAIDs (mefenamic acid or naproxen) were also found to produce clinically important reductions in menstrual blood loss, ranging from 20% to 49%, but were inferior to danazol and tranexamic acid, although NSAIDs have fewer adverse effects than danazol. 36,37 The NICE guidelines development group stated that, in its interpretation of the evidence for pharmaceutical treatments for HMB, a high value was placed on reduction of menstrual blood loss and minimising adverse effects.…”

Section: Introductionmentioning

confidence: 99%

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A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial

Gupta

Daniels

Middleton

et al. 2015

Health Technol Assess

324

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A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial Janesh K Gupta, 1,2 Jane P Daniels, 3 * Lee J Middleton, 3 Helen M Pattison, 4 Gail Prileszky, 5 Tracy E Roberts, 6 Sabina Sanghera, 6 Pelham Barton, 6 Richard Gray 7 and Joe Kai 5 on behalf of the ECLIPSE Collaborative Group This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 02/06/02. The contractual start date was in November 2004. The draft report began editorial review in February 2015 and was accepted for publication in May 2015. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publicati...

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Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding

Cited by 180 publications

References 27 publications

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Comparison of Therapeutic Efficacies of Norethisterone, Tranexamic Acid and Levonorgestrel-Releasing Intrauterine System for the Treatment of Heavy Menstrual Bleeding: A Randomized Controlled Study

Dysfunktionelle uterine Blutung

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial

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