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IUD May Be Best for Heavy Menstrual Bleeding

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WebMD Health News
Reviewed by Laura J. Martin, MD

Jan. 9, 2013 -- Heavy menstrual bleeding is a rarely discussed but remarkably common condition that affects about 1 in 4 women.

For many, monthly periods are much more than a minor annoyance. They stop life in its tracks for days each month.

Oral contraceptives and progestin hormone pills are commonly prescribed medical treatments for heavy periods in the U.S., but they aren’t always effective for many women.

Now a landmark study from Europe, published in the New England Journal of Medicine, concludes that an IUD that releases progestin may be a more effective therapy.  

IUD Worked Better Than Pill

The Mirena IUD implantable contraceptive was found to be superior to oral contraceptives and non-hormonal drugs approved for the treatment of heavy menstrual bleeding in reducing the condition's effect on quality of life.

The IUD is widely used in Europe to treat heavy menstrual bleeding, but it is not used as much in the U.S.

OBGYN professor Eve Espey, MD, of the University of New Mexico, says this is partly due to a bias toward surgical treatments in the U.S. and partly due to what she calls a “hangover” from negative feelings about IUDs dating back to the early 1970s.

That was when as many as 300,000 women who used an IUD known as the Dalkon Shield filed lawsuits claiming to have been injured by the device. The most common complaint was pelvic infection.

“The Dalkon Shield has given all IUDs a bad name for almost 40 years, but modern IUDs are really very safe,” she says.

Quality of Life Better With IUD

The study included 571 women with heavy periods followed for two years during treatment with either the Mirena IUD, oral hormone therapy, or the non-hormonal anti-bleeding drugs tranexamic acid and mefenamic acid.

Women who used the Mirena IUD reported greater improvement in quality of life, including their social routines, work-day routines, family life, and sex.

After two years, 64% of the women in the IUD group were still using the treatment vs. 38% of the women in the group using other treatments.

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