The effect of hysterectomy or levonorgestrel-releasing intrauterine system on sexual functioning among women with menorrhagia: a 5-year randomised controlled trial.
OBJECTIVE
To compare among women with menorrhagia the effect of hysterectomy or levonorgestrel-releasing intrauterine system (LNG-IUS) on sexual functioning.


METHODS
A randomised controlled trial.


METHODS
Five university hospitals in Finland.


METHODS
A total of 236 women, aged 35-49 years.


METHODS
Of the women, 117 were treated by hysterectomy and 119 by LNG-IUS.


METHODS
Sexual functioning was evaluated by modified McCoy sexual scale at baseline and at 6 months, 12 months, and 5 years after initiation of treatment (hysterectomy or application of LNG-IUS).


RESULTS
Among women treated by hysterectomy, sexual satisfaction increased and sexual problems decreased. Among LNG-IUS users, satisfaction with partner decreased. In addition to treatment modality (P = 0.02), estrogen therapy (P = 0.01), smoking (P = 0.001), night sweats (P = 0.03), vaginal dryness (P = 0.04), hot flushes (P = 0.01), and having someone to ask for advice (P = 0.03) and to share worries (P = 0.01) explained changes in sexual functioning.


CONCLUSIONS
Among women with menorrhagia, hysterectomy improves sexual functioning, whereas LNG-IUS does not have such a positive effect.
Halmesmäki
K
K
Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland. halmesma@mappi.helsinki.fi
Hurskainen
R
R
Teperi
J
J
Grenman
S
S
Kivelä
A
A
Kujansuu
E
E
Tuppurainen
M
M
Yliskoski
M
M
Vuorma
S
S
Paavonen
J
J
D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D012735:Sexual Dysfunction, Physiological / Q000517:prevention & control*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel