The effect of hysterectomy or levonorgestrel-releasing intrauterine system on sexual functioning among women with menorrhagia: a 5-year randomised controlled trial

Karoliina Halmesmäki, K. Halmesmäki, Ritva Hurskainen, R. Hurskainen, Juha Teperi, J. Teperi, S Grenman, Seija Grénman, Aarre Kivelä, A Kivelä, Erkki Kujansuu, E Kujansuu, M. Tuppurainen, M Yliskoski, Merja Yliskoski, S Vuorma, Sirkku Vuorma, J Paavonen, Jorma Paavonen
BJOG: An International Journal of Obstetrics & Gynaecology · 2007 · vol. 114(5) , pp. 563–568 · doi:10.1111/j.1471-0528.2007.01306.x · PMID:17439564 · W2054776513
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Hysterectomy improved sexual functioning in women with menorrhagia, while the levonorgestrel-releasing intrauterine system did not show a similar positive effect over five years.

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Abstract

OBJECTIVE: To compare among women with menorrhagia the effect of hysterectomy or levonorgestrel-releasing intrauterine system (LNG-IUS) on sexual functioning. DESIGN: A randomised controlled trial. SETTING: Five university hospitals in Finland. SAMPLE: A total of 236 women, aged 35-49 years. METHODS: Of the women, 117 were treated by hysterectomy and 119 by LNG-IUS. MAIN OUTCOME MEASURES: Sexual functioning was evaluated by modified McCoy sexual scale at baseline and at 6 months, 12 months, and 5 years after initiation of treatment (hysterectomy or application of LNG-IUS). RESULTS: Among women treated by hysterectomy, sexual satisfaction increased and sexual problems decreased. Among LNG-IUS users, satisfaction with partner decreased. In addition to treatment modality (P = 0.02), estrogen therapy (P = 0.01), smoking (P = 0.001), night sweats (P = 0.03), vaginal dryness (P = 0.04), hot flushes (P = 0.01), and having someone to ask for advice (P = 0.03) and to share worries (P = 0.01) explained changes in sexual functioning. CONCLUSIONS: Among women with menorrhagia, hysterectomy improves sexual functioning, whereas LNG-IUS does not have such a positive effect.

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MeSH descriptors

Contraceptive Agents, Female Hysterectomy Intrauterine Devices, Medicated Levonorgestrel Menorrhagia Sexual Dysfunction, Physiological Adult Contraceptive Agents, Female Female Humans Hysterectomy Levonorgestrel Menorrhagia Middle Aged Multivariate Analysis Patient Satisfaction Sexual Dysfunction, Physiological Statistics, Nonparametric Treatment Outcome

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