Is the levonorgestrel-releasing intrauterine system acceptable and safe for women with heavy menstrual bleeding?

The levonorgestrel‐releasing intrauterine system results in a larger reduction in menstrual blood loss from baseline in women with HMB compared with other medical treatments or placebo, including in selected women with fibroids. It appears to be more effective than oral medical therapies and results in better quality of life, higher satisfaction with treatment and lower withdrawal from treatment at two years. Both the LNG‐IUS and hysterectomy improve health‐related quality of life, which is most apparent within the 5 years after treatment. Although many women treated with the LNG‐IUS eventually have a hysterectomy (up to 46% within 10 years), the LNG‐IUS remains a cost-effective option.