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Coil a 'better heavy period remedy'

Scientists are suggesting that the hormone-releasing Mirena coil intrauterine device works better than conventional medical techniques when it comes to treating heavy menstrual periods.

It is believed the discovery could transform clinical practice, according to a study published in the New England Journal of Medicine.

Large numbers of women suffer from heavy periods, or menorrhagia. Around 20% of gynaecological referrals are taken up with the problem, and many GP consultations are taken regarding this problem, yet there is little evidence that both women and doctors are making informed choices about treating it.

The Eclipse trial looked at how the Mirena coil, which releases levonorgestrel, works in comparison with other treatments on offer. It examined 571 women suffering from heavy bleeding who agreed to be randomly assigned either the Mirena coil or a standard treatment. The latter including tranexamic acid, mefanamic acid, oestrogen and progestogen or progestogen only.

In the space of two years, patients reported that their symptoms improved more with the Mirena coil, also known as LNG-IUS, than with the other treatments. This had the benefit of boosting their social lives, both at work and in the family, as well as enhancing their mental wellbeing and general health.

Women who were treated with the coil were nearly twice as likely to be still using it after two years, as opposed to the other medication. Similarly, 49% of other people taking part in the trial switched to the coil owing to the reported “ineffectiveness” of other treatments.

Janesh Gupta, professor of obstetrics and gynaecology at the University of Birmingham, said: “While the interventions studied in this trial represent options available in primary care settings in the UK, insertion of IUDs is not part of primary care in all health care settings, and in some circumstances requires gynaecologist consultation.

“This trial should encourage the use of IUDs in primary care.”

Readers' comments (5)

  • i was given a mirena coil for my heavy periods fourteen years ago. it was fantastic. it stopped my periods completely. i also didnt want anymore children so it was a good contraceptive for me. i had one for about eight years. when it was taken out my periods did not resume,but, as i was premenopausal it didnt matter so i havent had a period for fourteen years. it has been a life changer and fantastic for me. i cannot recommend it highly enough and am surprised that it has only just been recognised. i have been talking about it for years.

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  • Can levonorgestrel not be given any other way? Pardon my ignorance! It's very instrusive to insert a coil, surely? I nursed an old lady who had a bad cervical infection, followed by a haemorrhage, from which she died, because a coil had been inserted, years before, in the US and not reported, nor removed. I know this must have been a one-off case but I would rather have a pill, if pos. than a coil.

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  • How about the newer flexible NuvaRing which looks safer and presumably women can insert themselves. these are now recomended as an alternative for Yasmin which has caused devastating effects through pulmonary emboli in some patients.

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  • I agree with the first post. I had a terrible time in my late 40's with heavy periods. I got to the stage where I was frightened to go anywhere as I flooded without warning and often with embarrassing results. My GP inserted Mirena, little sharp pain, but no other discomfort and from then until 5 years later I was pain free, and had no more periods. When it came out, I had no more as I was by then 53 years old. It has made the transition during menopause a dawdle. I have recommended it to my 3 sisters and any friend who discloses heavy, frequent periods with flooding.

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  • The Nuvaring is a combined hormonal contraceptive whereas the Mirena coil is progestogen only, therefore they are not comparable.

    The knowledge about the effects of the Mirena coil on heavy periods has been known for a long time in Family Planning circles. It is good to have more research to back this up.

    I am sorry to hear about the lady who died, but that was indeed a one-off and had factors associated with it such as it being left in for far longer than recommended. If inserted correctly and changed as recommended the IUD and IUS are very safe. For people who are not good at remembering to take their pill, LARC methods are an excellent alternative, and also come with the benefits to heavy periods as discussed here.

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