s. 2), and satisfaction with health (31 vs. 14). By the end of the two-year follow-up, 17 (53 percent) of the women in the medicine group had requested and received hysterectomy, and these women reported improvements in quality-of-life outcomes during the two years that were similar to those reported by women randomized to the hysterectomy group. Women who continued in the medical treatment also reported some improvements, with the result that most differences between randomized groups at the end of the study were no longer statistically significant in the intention-to-treat analysis."

"We have shown that hysterectomy results in substantial improvement in health-related quality of life within six months for women who have not responded to medroxyprogesterone. Persisting efforts at medical treatment can also produce benefits for many of these women throughout the ensuing two years although others who prolong medical treatment at this stage will decide within a year to have a hysterectomy," the authors conclude.

(JAMA 2004; 291:1447-1455. Available post-embargo at JAMA.com)

Editor's Note: This research was funded by a grant from the Agency for Healthcare Research and Quality.

FINNISH STUDY COMPARES INTRAUTERINE HORMONE-DELIVERY SYSTEM VS. HYSTERECTOMY

In a second study in the March 24/31 issue of JAMA, researchers from Finland compare outcomes, quality-of-life issues, and costs of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus hysterectomy in the treatment of menorrhagia (abnormally heavy menstrual bleeding).

"The LNG-IUS is an intrauterine system that releases 20 [micrograms] of levonorgesterel every 24 hours over 5 years. The LNG-IUS was developed during the 1980s and licensed first for contraception in Finland in 1990," the authors provide as background information. They add that in many countries, the LNG-IUS is licensed both for contraception and trea
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Contact: Eve Harris
415-885-7277
JAMA and Archives Journals
23-Mar-2004

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