The effect of hysterectomy or levonorgestrel-releasing intrauterine system on sexual functioning among women with menorrhagia:: a 5-year randomised controlled trial

Objective To compare among women with menorrhagia the effect of hysterectomy or levonorgestrel-releasing intrauterine system (LNG-IUS) on sexual functioning . Design A randomised controlled trial. Setting Five university hospitals in Finland. Sample A total of 236 women, aged 35-49 years. Methods Of the women, 117 were treated by hysterectomy and 119 by LNG-IUS. Main outcome measures Sexual functioning was evaluated by modified McCoy sexual scale at baseline and at 6 months, 12 months, and 5 years after initiation of treatment (hysterectomy or application of LNG-IUS). Results Among women treated by hysterectomy, sexual satisfaction increased and sexual problems decreased. Among LNG-IUS users, satisfaction with partner decreased. In addition to treatment modality (P = 0.02), estrogen therapy (P = 0.01), smoking (P = 0.001), night sweats (P = 0.03), vaginal dryness (P = 0.04), hot flushes (P = 0.01), and having someone to ask for advice (P = 0.03) and to share worries (P = 0.01) explained changes in sexual functioning. Conclusions Among women with menorrhagia, hysterectomy improves sexual functioning, whereas LNG-IUS does not have such a positive effect.