Most studies of women who have been treated for menorrhagia find that the women feel the maximum benefits in quality of life (QOL) come in the first 5 years after treatment, but those studies haven’t gone beyond 10 years in follow-up. Finnish researchers who reinterviewed study participants 10 years after their treatment found that the effects of treatment (hysterectomy or levonorgestrel-releasing intrauterine system [LNG-IUS]) had indeed peaked in the first 5 years. Any decline in health-related (HR) QOL thereafter, they say, was probably due to aging.
In their study, 236 women aged 35 to 49 years with menorrhagia were referred to 5 university hospitals in Finland and randomly assigned to treatment with hysterectomy or LNG-IUS. Follow-up visits took place at 6 months, 12 months, 5 years, and 10 years. The women completed questionnaires at each visit, including the Finnish version of the RAND 36-Item Health Survey (RAND-36) and the 5-Dimensional EuroQol (EQ-5D), which measures morbidity, self-care, usual activities, pain, and mood. Other scales measured anxiety, depression, and sexuality-related factors.
The baseline EQ-5D and RAND-36 scores of the study participants were significantly lower, the authors report, than the scores of age-matched Finnish women and, in fact, similar to the scores of women with chronic illness. Treating their menorrhagia boosted HRQOL and psychosocial well-being scores most strongly in the first year. However, between the fifth and tenth years, HRQOL declined by most measures. Sexual functioning was “substantially” impaired, for instance. Nevertheless, the researchers say, the HRQOL scores were still above or at least at the same level as baseline. The key seems to be that 10 years after the study, most of the women had entered or passed menopause (although follicle-stimulating hormone values were not measured).
Both treatments improved HRQOL, the researchers say. But, when helping a patient decide whether to have a hysterectomy or the LNG-IUS, they add that their findings showed that the LNG-IUS costs 31% less.
Source
Heliövaara-Peippo S, Hurskainen R, Teperi J, et al. Am J Obstet Gynecol. 2013;209(6):535.e1-535.e14.
doi: 10.1016/j.ajog.2013.08.041.
