For women with abnormally heavy menstrual bleeding, treatment with an intrauterine device that releases the hormone levonorgestrel appears to be less costly and equally, if not slightly more effective, than thermal balloon ablation, report investigators from New Zealand.
Thermal ablation involves inserting a balloon into the uterus, which is inflated and heated to destroy endometrial tissue lining the womb.
Dr. P. M. Brown and colleagues from University of Auckland determined the cost-effectiveness of the two treatments in 79 women seen at a menstrual disorders clinic at National Women’s Hospital in Auckland. Doctors placed the levonorgestrel-releasing IUD in 40 women, whereas 39 women underwent thermal ablation.
According to the team’s report in BJOG for July, the expected cost of treatment was $869 for IUD therapy and $1,693 for ablation, suggesting that the IUD system is a cost-effective treatment when compared with thermal balloon ablation, the team notes.
They also note that the IUD system was associated with slightly greater gains in overall quality of life.
Moreover, in a previous study comparing the efficacy of the IUD system with that of heat ablation, women treated with the IUD reported significantly less bleeding than those treated with ablation.
Collectively, the results suggest that the IUD system is associated with “better outcomes ... although the differences are slight,” notes the study team.
Brown and colleagues conclude that the levonorgestrel-releasing IUD “should be considered an effective alternative for the treatment of heavy menstrual bleeding.”
SOURCE: BJOG July 2006.
Revision date: June 14, 2011
Last revised: by Jorge P. Ribeiro, MD