A randomized controlled trial of hysterectomy or levonorgestrel‐releasing intrauterine system in the treatment of menorrhagia—effect on FSH levels and menopausal symptoms
Source: Human Reproduction, Volume 19, Number 2, February 2004 , pp. 378-382(5)
Publisher: Oxford University Press
Abstract:BACKGROUND: The purpose of this study was to compare the effects of hysterectomy and a levonorgestrel‐releasing intrauterine system (LNG‐IUS) on serum FSH levels and menopausal symptoms. METHODS: A total of 236 women referred for menorrhagia to five university hospitals were randomly assigned to treatment with hysterectomy (n = 117) or LNG‐IUS (n = 119). Menopausal symptoms were characterized by the Kupperman menopausal distress test. Serum FSH and estradiol levels were measured at baseline and 6 and 12 months after hysterectomy or application of LNG‐IUS. Analyses were by intention to treat. RESULTS: After 6 months, there was no difference between the groups, but 12 months after follow‐up hysterectomized women had higher FSH levels than women with LNG‐IUS (P = 0.005). There was a significant association between FSH levels and treatment modality (P = 0.020). Hot flushes increased significantly in the hysterectomy group (P = 0.02). There was a significant association between hot flushes and both treatment modality and age (P = 0.02 and P = 0.01, respectively). CONCLUSION: Hysterectomy may impair ovarian function shown by rising serum FSH levels and hot flushes. However, these results should be interpreted with caution, and longer follow‐up is needed.
Document Type: Research Article
Affiliations: 1: Department of Obstetrics and Gynecology, Central Hospital of Päijät‐Häme, Keskussairaalankatu 7, 15850 Lahti, 2: Department of Obstetrics and Gynecology, University of Helsinki and Health Services Research Unit, Stakes, Lintulahdenkuja 4, PL 220, 00531 Helsinki, 3: Department of Obstetrics and Gynecology, University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, 4: Health Services Research Unit, Stakes, Lintulahdenkuja 4, PL 220, 00531 Helsinki, 5: Department of Obstetrics and Gynecology, University of Turku, Kiinanmyllynkatu 4–8, 20520 Turku, 6: Department of Obstetrics and Gynecology, University of Oulu, Oulun yliopistollinen keskussairaala, PL22, 90221 Oulu, 7: Department of Obstetrics and Gynecology, University of Tampere, Tampereen yliopistollinen keskussairaala, PL 2000, 33521 Tampere and 8: Department of Obstetrics and Gynecology, University of Kuopio, Kuopion yliopistollinen sairaala, PL 1777, 70211 Kuopio, Finland
Publication date: 2004-02-01
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.