The Reproducibility of Treatment of Perimenopausal Abnormal Uterine Bleeding Due to Ovulatory Dysfunction with Hysteroscopic Endometrial Resection versus Mirena

Objective: To compare the efficacy of local levonorgestrel intrauterine releasing system and transcervical resection of the endometrium (TCER) in the management of perimenopausal dysfunctional uterine bleeding. Patients and Methods: This study was done at Ain Shams and Al-Azhar University Maternity Hospitals during a period started from January 2019 to January 2021. Patients were followed up at the outpatient gynaecology clinics at regular schedules (3, 6 and 12 months) for one year duration. Perimenopausal patients with DUB were assigned randomly to either the levonorgestrel intrauterine system (n = 35) or endometrial resection (n = 45). Blood loss assessment charts were used to measure menstrual blood loss. Results: Total bleeding score/month decreased from a baseline median of 47.26 to 33.5 (P<0.01) for the levonorgestrel intrauterine system and from 47.13 to 33.9 (P<0.01) for transcervical resection of the endometrium. There was no statically difference in bleeding score before and during treatment between the two groups of women. Conclusion: Both treatments levonorgestrel intrauterine system and transcervical resection of the endometrium efficiently reduced menstrual bleeding. levonorgestrel intrauterine system should be considered the first-line treatment for idiopathic menorrhagia because it is easy to insert, has a sustained effect, provides contraception, may reduce the need for surgery, and is cost-effective and well tolerated.