Cost-effectiveness and quality of life associated with heavy menstrual bleeding among women using the levonorgestrel-releasing intrauterine system.
OBJECTIVE
To review the literature for economic and health-related quality of life outcomes data associated with the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the management of heavy menstrual bleeding.


METHODS
We searched the MEDLINE and EMBASE databases simultaneously using the Ovid interface to review the literature in a systematic manner for economic and health-related quality of life outcomes data associated with the use of the LNG-IUS in women with heavy menstrual bleeding. Articles were then selected for further review based on the relevance of their titles and/or abstracts. We identified 17 articles for inclusion in this review.


RESULTS
Treating heavy menstrual bleeding with the LNG-IUS was found to be cost-effective in various countries and settings. Moreover, irrespective of the measuring instrument used, health-related quality-of-life outcomes were found to be improved to a degree similar to that achieved with endometrial ablation or hysterectomy. In some cases, the LNG-IUS appeared to be more effective and less costly than the surgical options.


CONCLUSIONS
The LNG-IUS is a cost-effective treatment option for heavy menstrual bleeding when pharmacologic treatment is indicated.
Department of Obstetrics and Gynecology, Stanford University, Stanford, USA.
Paul D
PD
Blumenthal
Lindsey
L
Dawson
Ritva
R
Hurskainen
D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000191:economics; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects* / Q000191:economics; D016912:Levonorgestrel / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use*; D008796:Metrorrhagia / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel