Contraceptive Pearl: Progestin IUD as Treatment for Menorrhagia

Heavy menstrual bleeding is the most common gynecological complaint. The progestin IUD is not only one of the most effective forms of contraception, but also a safe and useful treatment for menorrhagia.

A 2015 Cochrane review compared the progestin IUD to other treatments for menorrhagia. The seven studies comparing the progestin IUD with oral treatments (including norethisterone acetate, medroxyprogesterone acetate, the oral contraceptive pill, and mefenamic acid) found that the progestin IUD was more effective at reducing menorrhagia and improving quality of life, and was more likely to be continued after 2 years of treatment. While the ten studies comparing the progestin IUD with endometrial destruction techniques (transcervical resection, rollerball and thermal balloon abalation) found minor differences in reduction in bleeding outcomes, satisfaction, and quality of life, the progestin IUD appeared more cost effective within a two-year time frame. Although three studies confirmed hysterectomy was the most effective way to reduce menorrhagia, the progestin IUD was found to be more cost effective.

The progestin IUD is a safe and effective method of decreasing menstrual bleeding which spares future fertility and decreases costs.


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Helpful Resources

Progestin IUD User Guide

Medical Eligibility for Initiating Contraception



Lethaby A, Hussain M, Rishworth JR, Rees MC. Use of progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane 2015.

Gupta JK, Daniels, JP, Middleton LJ, et al. A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial. Health Technology Assessment 2015. 19(88).



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.