الفهرس 
. Diagnosis of menorrhagia
Medical treatmentOnly 14 pages are availabe for public view
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Abstract
Aim of review:This review is carried out to evaluate the current status concerning the use of levonorgestrel intrauterine system as hysterectomy alternative for the treatment of menorrhagia in terms of safety, effectiveness, cost/benefit ratio, potential risk, and life style. Findings: Menorrhagia is a common gynecologic problem as about 30% of women of reproductive age complain of menorrhagia, and it accounts for 5% of all gynecologic consultations each year. Menorrhagia significantly interferes with the daily activities and has a negative impact on quality of life. Women suffering from heavy monthly bleeding are often anemic and in ill health. Diagnosis of menorrhagia starts by history and clinical examination. Ultrasonography, sonohysterography and hysteroscopy are additional investigations that may diagnose a structural problem and should be utilized depending on their availability and the experience of the surgeon. Medical treatment is usually the first line in the treatment of menorrhagia and surgical treatment often follows failed or ineffective medical therapy. Hysterectomy has been regarded as the definitive surgical treatment for intractable heavy menstrual bleeding but in spite of a 100% success rate and high levels of satisfaction, it is a major surgical procedure with significant physical and emotional complications and a social and economic cost. Endometrial ablation and uterine artery embolization especially in the presence of uterine fibroids have all been shown to improve the symptom of heavy menstrual bleeding considerably. Compared with a hysterectomy, these procedures carry a substantially lower risk of morbidity. In recent years, it has been shown that levonorgestrel intrauterine system is a potential alternative to minimal invasive surgical techniques in the treatment of menorrhagia. With its limited cost, reversibility in terms of fertility, contraceptive efficacy and effectiveness for five years, it seems to have additional advantages to other alternatives. It has beneficial effects in patients with uterine fibroids, adenomyosis, endometriosis, and in protection against and treatment of endometrial hyperplasia and cancer. Conclusion: LNG-IUS is an effective method for treatment of menorrhagia and should be offered as an alternative to hysterectomy, which will decrease the number of hysterectomies performed for benign disorders and it is more cost effective than hysterectomy.