What are my treatment options?


  NovaSure Hormone
Releasing IUD
(Intrauterine device)		 D&C
(Dilation and curettage)		 Hormone Therapy Hysterectomy
(Removal of the uterus)
Description Simple, safe procedure that removes the lining of the uterus to reduce or eliminate bleeding Device inserted into the uterus that releases a steady amount of progestins, which can help control bleeding Surgical procedure used to temporarily control heavy bleeding by scraping the inside of the uterus. Primarily used as a diagnostic tool Low-dose estrogen/progestin used for selected low-risk patients Permanent, surgical option for women not responsive to other medical treatments
Advantages • Procedure takes approximately 4 minutes

• Simple, 90-second treatment

• Proven safe and effective1

• Requires no pretreatment

• Convenient—can be performed at any time during the menstrual cycle

• Rapid recovery

• Excellent success rate

• Removes uterine lining while preserving uterus

 • Convenient—inserted into the body

• Reduces problem bleeding in about 70% of patients2

• Local delivery of hormone, thereby minimizing systemic side effects

• Contraceptive

• Reversible

 • Temporary reduction in bleeding4

• Important diagnostic tool that can provide tissue sample to test for cancer of the uterus

 • Helps control problem bleeding in about 50% of patients5

• Convenient —
self-administered

• Contraceptive

• Reversible

 • Eliminates problem
bleeding

• Permanent
Disadvantages • Only appropriate for women who have completed childbearing

• Requires anesthesia: local or general

 • Must be removed and replaced per manufacturer’s designated intervals

• Intermenstrual bleeding3

• Possible hormonal side effects
(ie, depression, acne, headache, weight change)3

 • Requires anesthesia

• Reduction in bleeding
is temporary4

 • Hormonal side effects5

• Cost issues

• Results vary depending on which hormone is used6

• Must select appropriate hormonal management approach6

• Contraindications may rule out some women

 • Cost

• Involves major invasive surgery

• Risk of complications

• Requires general or regional anesthesia

• 2- to 8-week recovery time

• May result in early onset of menopause/possible need for future hormone treatment7

• Non-reversible

References: 1. Cooper J, et al. A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia. J Am Assoc Gynecol Laparosc. 2002;9:418-428. 2. Istre O, et al. Treatment of menorrhagia with levonorgestrel intrauterine system versus endometrial resection. Fertil Steril. 2001;76:304-309. 3. Hurskainen R, et al. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up. JAMA. 2004;291:1456-1463. 4. DeCherney AH, et al. Current Obstetric & Gynecologic Diagnosis & Treatment. 9th ed. New York, NY: McGraw-Hill Medical; 2003. 5. Cooper KG, et al. A randomised comparison of medical and hysteroscopic management in women consulting a gynaecologist for treatment of heavy menstrual loss. Br J Obstet Gynaecol. 1997;104:1360-1366. 6. Singh RH, et al. Hormonal management of abnormal uterine bleeding. Clin Obstet Gynecol. 2005;48:337-352. 7. Siddle N, et al. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril. 1987;47:94-100.