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IUS may be best for heavy periods

Inserting an intrauterine system (IUS), like the Mirena coil, may be the best treatment for heavy menstrual periods. 

The study by scientists from Nottingham and Birmingam Universities, published in the New England Journal of Medicine showed that patient's physical and psychological health improved more using the Mirena coil than with other treatments over two years. 

Lead author of the study, Dr Joe Kai, a GP and Professor of Primary Care at The University of Nottingham, said: “This trial tells us not only that treatments can be effective, but also what to choose, bearing in mind a woman's preferences for having a contraceptive inserted or not.”

The 571 participants were randomly assigned to standard medical treatments, such as a combined estrogen and progestogen or progestogen only pill, or tranexamic acid, also known as Femstrual.

Menorrhagia, or heavy periods, affects 20-30% of women of reproductive age. 

The National Institute for Clinical Excellence (NICE) recommends medication as the first line of treatment for women who have no symptoms of an underlying serious cause, but IUSs are also a sanctioned treatment. 

Debby Holloway from the RCN Women's Health Forum, and a nurse consultant in gynaecology said: “This is an important trial that highlights the effectiveness of the intrauterine system in the treatment of heavy periods as was suggested by the NICE guidance.

“Anything that can help women to mange their bleeding and lead to an improved quality of life is welcome and should be discussed widely with women. 

Janesh Gupta, Professor of Obstetrics and Gynaecology at the University of Birmingham and based at Birmingham Women's Hospital, said: “While the interventions studied in this trial represent options available in primary care settings in the UK, insertion of an intrauterine system is not part of primary care in all health care settings, and in some circumstances requires gynaecologist consultation. 

“This trial should encourage the use of IUSs in primary care.”

While using an IUS may lessen the effects of menorrhagia, copper coils or IUDs may often have the opposite effect. This article was amended on 21 January to reflect that fact.