title: Randomised comparative trial of the levonorgestrel intrauterine system and norethisterone for treatment of idiopathic menorrhagia.
abstract: OBJECTIVE
  To compare the efficacy and acceptability of the levonorgestrel intrauterine system and norethisterone for the treatment of idiopathic menorrhagia.
  
  
  METHODS
  A randomised comparative parallel group study.
  
  
  METHODS
  Gynaecology outpatient clinic in a teaching hospital.
  
  
  METHODS
  Forty-four women with heavy regular periods and a measured menstrual blood loss exceeding 80 ml.
  
  
  METHODS
  Twenty-two women had a levonorgestrel intrauterine system inserted within the first seven days of menses, and 22 women received norethisterone (5 mg three times daily) from day 5 to day 26 of the cycle for three cycles.
  
  
  METHODS
  The main outcome measure was the change in objectively assessed menstrual blood loss after three months of treatment.
  
  
  RESULTS
  When menstrual blood loss at three months was expressed as a percentage of the control, the levonorgestrel intrauterine system reduced menstrual blood loss by 94% (median reduction 103 ml; range 70 to 733 ml), and oral norethisterone by 87% (median reduction 95 ml; range 56 to 212 ml). After three cycles of treatment 76% of the women in the levonorgestrel intrauterine system group wished to continue with the treatment, compared with only 22% of the norethisterone group.
  
  
  CONCLUSIONS
  Both the levonorgestrel intrauterine system and oral norethisterone in this regimen provided an effective treatment for menorrhagia in terms of reducing menstrual blood loss to within normal limits. The levonorgestrel intrauterine system was associated with higher rates of satisfaction and continuation with treatment, and thus offers an effective alternative to currently available medical and surgical treatments for menorrhagia.
authors.affiliation: University of Glasgow Department of Obstetrics and Gynaecology, Glasgow Royal Infirmary NHS Trust.
authors.forename: G A
authors.initials: GA
authors.lastname: Irvine
authors.forename: M B
authors.initials: MB
authors.lastname: Campbell-Brown
authors.forename: M A
authors.initials: MA
authors.lastname: Lumsden
authors.forename: A
authors.initials: A
authors.lastname: Heikkilä
authors.forename: J J
authors.initials: JJ
authors.lastname: Walker
authors.forename: I T
authors.initials: IT
authors.lastname: Cameron
mesh_terms: D000328:Adult; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D008595:Menorrhagia / Q000097:blood / Q000188:drug therapy*; D008598:Menstruation; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D045167:Progesterone Congeners / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000139:chemically induced
chemical_list: D006454:Hemoglobins; D045167:Progesterone Congeners; D016912:Levonorgestrel; D005293:Ferritins; D009640:Norethindrone