Medical treatment for menorrhagia may only delay hysterectomy

Some women with abnormal uterine bleeding may be able to avoid hysterectomy by making the best use of available medical options. But the results of two new studies show that despite aggressive medical management most women with menorrhagia unrelated to pregnancy or malignancy will eventually need surgery and will undergo additional suffering by forestalling more definitive treatment (JAMA 2004;291:1447-55,1456-63).

The two studies contained some conflicting conclusions and differed with respect to the controls. The first study used “expanded medical therapy” with sex steroid hormones or prostaglandin synthetase inhibitors, or both. The other study used an intrauterine administration of a continuous release progestational hormone that is only available for this indication in Europe (marketed as Mirena by Schering Health).

The …