Levonorgestrel Intrauterine System — First-Line Therapy for Heavy Menstrual Bleeding

Heavy menstrual bleeding, or menorrhagia, affects up to 30% of women during their reproductive years, negatively affecting their quality of life1,2 and exacting a high price from the health care system.3 Several studies have assessed the effectiveness and cost-effectiveness of various medical and surgical therapies,46 but a clearly superior approach to management of heavy menstrual bleeding remains elusive.In this issue of the Journal, Gupta et al.7 provide data from a multicenter, randomized, controlled trial showing the superiority of the levonorgestrel intrauterine system (levonorgestrel-IUS) over other usual medical treatments in improving quality of life for women who sought . . .