What do systematic reviews say?

LNG‐IUS vs any other medical treatment

• Progestogen‐releasing intrauterine systems for heavy menstrual bleeding 2020 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 170 participants
  Low

LNG‐IUS vs hysterectomy

It is very uncertain whether LNG‐IUS changes bleeding compared with hysterectomy (very low certainty).

• Progestogen‐releasing intrauterine systems for heavy menstrual bleeding 2020 · Cochrane Headline outcomes only
  RR 0.52 [0.39, 0.7]
  1 study · 75 participants
  Very low

LNG‐IUS vs endometrial ablation

• Progestogen‐releasing intrauterine systems for heavy menstrual bleeding 2020 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 122 participants
  Very low

LNG‐IUS vs non‐intrauterine progestogen

It is very uncertain whether LNG‐IUS changes adverse effects associated with hormones:Bleeding/spotting Nausea… compared with non‐intrauterine progestogen (very low certainty).

• Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia 2020 · Cochrane Headline outcomes only
  OR 2.13 [1.33, 3.43]
  3 studies · 428 participants
  Very low

Surgery vs LNG‐IUS

Surgery probably leads to higher objective control of bleeding: menstrual loss under 80 ml per cycle… compared with LNG‐IUS (moderate certainty).

• Surgery versus medical therapy for heavy menstrual bleeding 2016 · Cochrane Headline outcomes only
  RR 1.11 [1.05, 1.19]
  1 study · 223 participants
  Moderate

Surgery vs LNG‐IUS

Surgery may leads to higher subjective control of bleeding: PBAC no more than 75 per cycle… compared with LNG‐IUS (low certainty).

• Surgery versus medical therapy for heavy menstrual bleeding 2016 · Cochrane Headline outcomes only
  RR 1.19 [1.07, 1.32]
  5 studies · 281 participants
  Low

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance probably leads to higher abnormal vaginal bleeding or spotting compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 7.26 [3.37, 15.66]
  3 studies · 376 participants
  Moderate

LNG‐IUS vs medroxyprogesterone (MPA) 10 mg

Levonorgestrel‐releasing intrauterine system (LNG‐IUS) may leads to higher vaginal bleeding over 6‐month compared with medroxyprogesterone (MPA) 10 mg (low certainty).

• Oral and intrauterine progestogens for atypical endometrial hyperplasia 2018 · Cochrane Headline outcomes only
  OR 2.89 [1.11, 7.52]
  1 study · 153 participants
  Low