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Heavy menstrual bleeding should not necessarily lead to hysterectomy

A report by NICE has recommended the use of Mirena® (the levonorgestrel-releasing intrauterine system [IUS] from Schering Health Care) for firstline treatment of heavy menstrual bleeding (HMB) in women for whom hormonal treatment is appropriate.

The guidance marks a move from the practices of the early 1990s when, says the guideline, it was estimated that at least 60% of women presenting with HMB would have a hysterectomy - often as a firstline treatment.

Schering medical director, Dr Rebecca Curtis, commented: "This guidance is good news for clinicians and patients alike. It offers a clear evidence-based pathway for the management of HMB, which adversely affects the quality of life of many women.

"As well as its therapeutic use in this condition, the IUS also offers a reliable form of long-acting contraception (LARC), which lasts up to five years, as previously recommended by the NICE LARC guideline."

Leading GP and RCGP women's health spokesperson, Dr Sarah Jarvis, said: "The levonorgestrel-releasing IUS, as an extremely reliable and convenient form of contraception with a high satisfaction rate, is one which I regularly recommend to patients both for contraception and for the treatment of HMB.

"I welcome the NICE guidance, which confirms its place as a first-line treatment for the management of HMB in women for whom hormonal treatment is appropriate."