A randomized controlled trial of hysterectomy or levonorgestrel-releasing intrauterine system in the treatment of menorrhagia-effect on FSH levels and menopausal symptoms.
BACKGROUND
The purpose of this study was to compare the effects of hysterectomy and a levonorgestrel-releasing intrauterine system (LNG-IUS) on serum FSH levels and menopausal symptoms.


METHODS
A total of 236 women referred for menorrhagia to five university hospitals were randomly assigned to treatment with hysterectomy (n = 117) or LNG-IUS (n = 119). Menopausal symptoms were characterized by the Kupperman menopausal distress test. Serum FSH and estradiol levels were measured at baseline and 6 and 12 months after hysterectomy or application of LNG-IUS. Analyses were by intention to treat.


RESULTS
After 6 months, there was no difference between the groups, but 12 months after follow-up hysterectomized women had higher FSH levels than women with LNG-IUS (P = 0.005). There was a significant association between FSH levels and treatment modality (P = 0.020). Hot flushes increased significantly in the hysterectomy group (P = 0.02). There was a significant association between hot flushes and both treatment modality and age (P = 0.02 and P = 0.01, respectively).


CONCLUSIONS
Hysterectomy may impair ovarian function shown by rising serum FSH levels and hot flushes. However, these results should be interpreted with caution, and longer follow-up is needed.
Halmesmäki
K
K
Department of Obstetrics and Gynecology, Central Hospital of Päijät-Häme, Keskussairaalankatu 7, 15850 Lahti, Finland. halmesma@mappi.helsinki.fi
Hurskainen
R
R
Tiitinen
A
A
Teperi
J
J
Grenman
S
S
Kivelä
A
A
Kujansuu
E
E
Yliskoski
M
M
Paavonen
J
J
D000328:Adult; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D019584:Hot Flashes; D006801:Humans; D007044:Hysterectomy; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D016015:Logistic Models; D008593:Menopause; D008595:Menorrhagia / Q000628:therapy*; D016017:Odds Ratio
D004958:Estradiol; D016912:Levonorgestrel; D005640:Follicle Stimulating Hormone