Cost-effectiveness and quality of life associated with heavy menstrual bleeding among women using the levonorgestrel-releasing intrauterine system

Int J Gynaecol Obstet. 2011 Mar;112(3):171-8. doi: 10.1016/j.ijgo.2010.08.025. Epub 2011 Jan 26.


Objective: To review the literature for economic and health-related quality of life outcomes data associated with the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the management of heavy menstrual bleeding.

Methods: We searched the MEDLINE and EMBASE databases simultaneously using the Ovid interface to review the literature in a systematic manner for economic and health-related quality of life outcomes data associated with the use of the LNG-IUS in women with heavy menstrual bleeding. Articles were then selected for further review based on the relevance of their titles and/or abstracts. We identified 17 articles for inclusion in this review.

Results: Treating heavy menstrual bleeding with the LNG-IUS was found to be cost-effective in various countries and settings. Moreover, irrespective of the measuring instrument used, health-related quality-of-life outcomes were found to be improved to a degree similar to that achieved with endometrial ablation or hysterectomy. In some cases, the LNG-IUS appeared to be more effective and less costly than the surgical options.

Conclusion: The LNG-IUS is a cost-effective treatment option for heavy menstrual bleeding when pharmacologic treatment is indicated.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Contraceptive Agents, Female / therapeutic use*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Hysterectomy / economics
  • Intrauterine Devices, Medicated / adverse effects*
  • Intrauterine Devices, Medicated / economics
  • Levonorgestrel / adverse effects*
  • Levonorgestrel / economics
  • Levonorgestrel / therapeutic use*
  • Metrorrhagia / drug therapy*
  • Metrorrhagia / economics
  • Metrorrhagia / surgery
  • Quality of Life*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Contraceptive Agents, Female
  • Levonorgestrel