As for as the measurements of success based on quality of life, Mirena beat out all the other therapies for heavy menstrual bleeding. Of the women who were not successfully treated they wound up having either an endometrial ablation or a hysterectomy about 10% of the time in both groups. In a review article on non-surgical management of heavy menstrual bleeding in the March issue of Obstetrics & Gynecology they looked at the 26 well done studies of all therapies they could find short of surgery. In this review article they felt 26 studies were not a lot to depend upon, and there was a caviat to be taken into consideration, the research studies look at only heavy bleeding, not "patient experience." It is uncommon for them to look out farther than a few months, although it was studied for up to a year in some studies.
It is also concerning that there were no real quality of life studies that were large enough to really answer questions like: will you still have PMS, will you still have cramps, will you have wight gain, will you have bloating, will you overall be better enough that you feel better from treating the heavy bleeding with one treatment vs the other. Also studies that combine therapies are lacking, and that is something that just your gyno needs to work out for you on her own. For women who do not want children, endometrial ablation, particularly with NovaSure, can be successful about 90+% of time, and can be accomplished in a comfortable office setting. NovaSure treatment has been shown to reduce PMS, reduce the symptoms around the heavy bleeding so even cramping and bloating are improved.
For women who receive a Mirena IUD some spotting or irregular bleeding in the first three months is very common. Recent studies have tried to come up with specific treatments for the irregular bleeding, and none was any better than just waiting it out. The hormone levels of Mirena are low, but still some women will report side effects. No hormonal side effects either mood changes or weight gain has been reported for women receiving NovaSure and it appears that at one year there is a bit more data on quality of life. For women considering their options, call 217-356-3736 to schedule an appointment with www.womenshealthpractice, or go to the website and email for an appointment.