Excessive menstrual bleeding is a highly treatable condition that affects 1 out of every 5 women
Use this chart as a handy reference when discussing and considering the most common treatment options
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NovaSure®
Endometrial
Ablation |
Hormone
Releasing IUD
(Intrauterine device) |
Hormone Therapy |
D&C
(Dilation and curettage) |
Hysterectomy
(Removal of the uterus) |
| Description |
Simple, safe procedure that removes uterine lining while preserving the uterus to reduce or eliminate bleeding |
Device inserted into the uterus that releases a steady amount of progestins, which can
help control bleeding |
Estrogen/used for
select low-risk patients |
Surgical procedure used to temporarily control heavy bleeding by scraping the inside of the uterus |
Permanent, surgical option for women not responsive to other treatments |
| Advantages |
• Reduces problem bleeding in about 91% of patients1
• Approximately 90 - second treatment time*
• Procedure takes less than 5 minutes*
• Can be performed at any time during the menstrual cycle
• Can be performed in the doctor’s office
• Rapid recovery
|
• Reduces problem bleeding in about 70% of patients2
• Contraceptive
• Effective for 5 years
• Retain fertility (when IUD is removed)
|
• Reduces problem bleeding in about half of patients6
• Self-administered
• Contraceptive
• Retain fertility (when therapy is stopped)
|
• Diagnostic tool that can provide tissue sample to test for cancer of the uterus
• Retain fertility
|
• Eliminates problem
bleeding
• Permanent
|
| Disadvantages |
• Only appropriate for women who have completed childbearing
• Requires anesthesia: local or general
• Non-reversible – lose fertility
•Risk of complications associated with minimally invasive procedures
|
• Must be removed and replaced every 5 years
• 70% of women experience intermenstrual bleeding/spotting3
• 30% of women experience hormonal side effects3
Hormonal side effects may include: depression4, acne4, headaches4, nausea4, weight gain4, and hair loss5
• Other potential side effects include abdominal pain, infection, and difficulty inserting the device, requiring cervical dilation2
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• Hormonal side effects may include: nausea, headaches and weight gain6
• Results may vary depending on hormone7
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• Requires anesthesia
• Reduction in bleeding
is temporary8
• Risk of complications associated with minimally invasive procedures
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• Cost
• Involves major invasive surgery
• Risk of complications associated with major surgery
• Requires general or regional anesthesia
• 2- to 8-week recovery time
• May result in early onset of menopause/possible need for future hormone treatment9
• Non-reversible - lose fertility
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References:
1. Cooper J, et al. A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia. J Am Assoc Gynecol Laparosc. 2002;9:418-428.
2. Istre O, et al. Treatment of menorrhagia with levonorgestrel intrauterine system versus endometrial resection. Fertil Steril. 2001;76:304-309.
3. Hurskainen R, et al. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up. JAMA. 2004;291:1456-1463.
4. Mirena [page insert]. Wayne, NJ: Bayer HealthCare Pharmaceuticals Inc.; 2007.
5. Backman T, Huhtala S, Blom T, Luoto R, Rauramo I, Koskenvuo M. Length of use and symptoms associated with premature removal of levonorgestrel intrauterine system:
a nation-wide study of 17,360 users. BJOG 2000; 107:335-9.
6. Cooper KG, et al. A randomised comparison of medical and hysteroscopic management in women consulting a gynaecologist for treatment of heavy menstrual loss. Br J Obstet Gynaecol. 1997;104:1360-1366.
7. Singh RH, et al. Hormonal management of abnormal uterine bleeding. Clin Obstet Gynecol. 2005;48:337-352.
8. DeCherney AH, et al. Current Obstetric & Gynecologic Diagnosis & Treatment. 9th ed. New York, NY: McGraw-Hill Medical; 2003.
9. Siddle N, et al. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril. 1987;47:94-100.
* The average treatment time is 90 seconds, and the entire NovaSure procedure typically takes less than 5 minutes to complete.
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