Brazilians Did Better with Mirena IUD than Endometrial Ablation

In a five year study from the April Issue of Contraception looking at women who have used a Endometrial Ablation vs Women who had a Mirena IUD, more Brazilians ended up with hysterectomy in the Endometrial Ablation group. My first thought is that women with worse cases would select a Endometrial Ablation, but it was actually a randomized trial in that the authors took 84 women who had heavy bleeding that needed treatment and randomized them to either treatment with either endometrial ablation or the IUD with preogesterone which is approved for the treatment of heavy menstrual bleeding. They point out that hysterectomy is always 'the most effective' therapy for heavy periods, but that it is both more risky and less acceptable to women, and no longer the treatment of first choice for this condition. The study actually followed women out for 5 years. When physicians talk about success rates of treatments they often have only 6, 12, or 24 months of data and really couldn't give as many statistics after 5 years. Interestingly, there were no people in the IUD group that actually had worse bleeding at the end of their 5 years, and many with no periods at all. In their ablation group, there were some with worse bleeding, and none of the Endometrial Ablation
patients still had no periods at all. There were other aspects to the cases, more Mirena users said they would do this again after 5 years, and yet both groups found their quality of life and satisfaction with the procedure about the same.  Many women have bleeding right before they go into menopause, women entering menopause, and stopping menstrual periods naturally affects the outcome of a study like this one with relatively few patients. But be sure to gab with your gyno regarding alternatives when you have heavy menstrual bleeding.


  1. It was Thermachoice, not Novasure


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