Hormone-Releasing Intrauterine Device (IUD)

Hormones don't reliably help with heavy menstrual bleeding

In addition to not being indicated for use in the treatment of menorrhagia, hormone-releasing IUDs have high discontinuation rates among women when used for the treatment of menorrhagia. A recent 5-year study published in the Journal of the American Medical Association found that <50% of patients continued to use the IUD. Further, 42% of those women in the study went on to have a hysterectomy.1 With the introduction of other more definitive technologies, the IUD is less frequently utilized as a treatment choice in the US.

Data from a 5-year, randomized, controlled study of women with menorrhagia (N=119). Women were randomized to LNG-IUS or hysterectomy.1

Discontinuation in women still using the hormone-releasing IUD is often attributed to common breakthrough bleeding, which is inconvenient and difficult to manage. The most common side effects resulting in discontinuation of levonorgastrel intra-uterine system therapy include irregular bleeding and hormonal side effects such as breast tenderness, mood changes and acne. Other potential drawbacks include abdominal pain, infection and difficult insertions requiring cervical dilation 3.