Can the levonorgestrel intrauterine system replace surgical treatment for the management of menorrhagia?

Menorrhagia is a common gynaecological condition for which medical treatment is often ineffective and a large number of women undergo major surgery. Previous short term studies have shown a significant number of women with menstrual problems may avoid surgery if a levonorgestrel intrauterine system (LNG-IUS) is fitted but no long term studies exist to ascertain if this benefit is sustained. This four to five year long term follow up study showed 50% of women continued to use the device and 67.4% avoided surgery. The LNG-IUS is well accepted and effective in the management of menorrhagia and has major cost implications to the National Health Service.