Mirena: a non-surgical treatment for heavy periods
29 March 2002
UK researchers have concluded that the levonorgestrel intrauterine system Mirena offers a simple and effective alternative to surgical treatment for menorrhagia (heavy periods).
The finding has led to a call in Australia for Mirena to be available on the Pharmaceutical Benefits Schedule for women who haven't responded to other methods of treatment.
'In the 5 years it has been available in Britain they've been able to reduce their hysterectomy rate for dysfunctional uterine bleeding by about 40 per cent,' said Dr Terri Foran, medical director of FPA Health.
She said Mirena had been available on private script in Australia since early last year, which had limited its use a bit.
'I consider it to be an excellent method of contraception with a failure rate of 0.2 per cent and a useful method of controlling heavy bleeds in women who may in fact be looking at a much more invasive surgical option as an alternative,' she said.
'Certainly for my patients I would recommend it as a choice before considering hysterectomy, provided they don't, for example, have huge fibroids.'
The UK researchers recruited women who had failed to respond to a combination of antiprostaglandins and antifibrinolytics, and were waiting for either endometrial ablation or hysterectomy.
Of the 23 women who reported using the system after an average 53.5 months, 8 were amenorrhoeic (had no periods), 13 described occasional bleeding and 2 had regular cyclical bleeding. Only one woman had moderate bleeding with clots.
Weight gain was the most common side-effect, which was reported by 11 women. Bloating, mastalgia (breast pain) and depression were also noted.
'The system offers a simple and effective alternative to surgical treatment for menorrhagia, with a concomitant reduction in surgical morbidity and mortality,' the researchers concluded in the British Journal of Obstetrics and Gynaecology (2002; 109: 345-47).
Last Reviewed: 05 April 2002
- 1. Medical Observer Weekly 29/03/02
