Medicine

Combined Treatment Reduces Heavy Menstrual Bleeding Better Than Ablation Alone

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Menstrual cycleEndometrial ablation

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This randomised controlled trial conducted in The Netherlands compared the effectiveness of endometrial ablation combined with a levonorgestrel-releasing intrauterine system (LNG-IUS) versus endometrial ablation alone for treating heavy menstrual bleeding. The study found that the combination therapy significantly reduced the incidence of hysterectomy compared to ablation alone, without increasing complication risks. The combined treatment demonstrates a safe and effective adjunctive strategy for managing heavy menstrual bleeding.


This finding offers women with heavy menstrual bleeding a more effective treatment option that may help them avoid hysterectomy, a major surgical procedure. The combination therapy could become a preferred first-line intervention, potentially reducing healthcare costs and improving quality of life for patients seeking alternatives to surgical removal of the uterus.


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The combination of endometrial ablation and LNG-IUS significantly reduced the incidence of hysterectomy compared with endometrial ablation alone. The combined treatment appears to be a safe adjunctive strategy for heavy menstrual bleeding that does not increase the risk of complications.

Source: [Articles] Endometrial ablation plus levonorgestrel-releasing intrauterine system versus endometrial ablation alone in women with heavy menstrual bleeding in The Netherlands (MIRA2): a multicentre, open-label, randomised, controlled, superiority trial