LA JOLLA, CALIF. — Hysterectomy and the levonorgestrel-releasing intrauterine system are equally effective for improving sexual functioning in women being treated for menorrhagia, Dr. Karoliina Halmesmaki said.
“One-third of women suffer from menorrhagia during their reproductive years, and as a result have a lower quality of life,” she said at the annual meeting of the Association of Reproductive Health Professionals.
The most common surgical treatment for this condition is hysterectomy, which has the potential to affect sexual functioning by disrupting the vaginal nerve supply and changing pelvic anatomy, explained Dr. Halmesmaki, a professor in the department of obstetrics and gynecology at the University of Helsinki.
“Previous randomized controlled trials comparing hysterectomy with medical treatment … have produced controversial results. The aim of our study was to compare these two treatments' effects on sexual functioning,” she said.
The study included 236 nondepressed women aged 35–49 years who were referred for menorrhagia to five university hospitals in Finland. Equal numbers of women were matched and randomized to either surgery or a levonorgestrel-releasing intrauterine system (LNG-IUS). Sexual functioning was assessed by a modified McCoy sexual scale, a questionnaire addressing sexual satisfaction, partner satisfaction, and sexual problems.
“Sexual satisfaction increased in both groups at 6 months' follow-up, but more so in the hysterectomy group,” Dr. Halmesmaki said. “However, the two groups did not differ at 12 months and 5 years.”
Sexual problems decreased among women with hysterectomies at 6 and 12 months, but again, there was no group difference at the 5-year follow-up.
“Interestingly, even though the two groups did not differ with regard to sexual satisfaction or sex problems at 5 years, the women using LNG-IUS were less satisfied with their partners at 1 year and beyond,” Dr. Halmesmaki said.