Mirena Obstetrics and Gynecology, Public Health Institute, Oulu Finland, Kuopio Finland, National Public Health Institute
The effect of hysterectomy or levonorgestrel-releasing intrauterine system on sexual functioning among women with menorrhagia: a 5-year randomised controlled trial
K Halmesmäki,aa Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, FinlandDr K Halmesmäki, Department of Obstetrics and Gynecology, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. Email halmesma@mappi.helsinki.fi R Hurskainen,aa Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland J Teperi,b b Health Services Research Unit, STAKES, Helsinki, Finland S Grenman,c c Department of Obstetrics and Gynecology, University of Turku, Turku, Finland A Kivelä,d d Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland E Kujansuu,e e Department of Obstetrics and Gynecology, University of Tampere, Tampere, Finland M Tuppurainen,f f Department of Obstetrics and Gynecology, University of Kuopio, Kuopio, Finland M Yliskoski,g g Central Hospital of Central Finland, Jyväskylä, Finland S Vuorma,h h National Public Health Institute, Helsinki, Finland J Paavonenaa Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finlanda Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland b Health Services Research Unit, STAKES, Helsinki, Finland c Department of Obstetrics and Gynecology, University of Turku, Turku, Finland d Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland e Department of Obstetrics and Gynecology, University of Tampere, Tampere, Finland f Department of Obstetrics and Gynecology, University of Kuopio, Kuopio, Finland g Central Hospital of Central Finland, Jyväskylä, Finland h National Public Health Institute, Helsinki, Finland
Dr K Halmesmäki, Department of Obstetrics and Gynecology, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. Email halmesma@mappi.helsinki.fi
Abstract
Objective To compare among women with menorrhagia the effect of hysterectomy or levonorgestrel-releasing intrauterine system (LNG-IUS) on sexual functioning . ... more »
The effect of hysterectomy or levonorgestrel-releasing intrauterine system on sexual functioning among women with menorrhagia: a 5-year randomised controlled trial
K Halmesmäki,aa Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, FinlandDr K Halmesmäki, Department of Obstetrics and Gynecology, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. Email halmesma@mappi.helsinki.fi R Hurskainen,aa Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland J Teperi,b b Health Services Research Unit, STAKES, Helsinki, Finland S Grenman,c c Department of Obstetrics and Gynecology, University of Turku, Turku, Finland A Kivelä,d d Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland E Kujansuu,e e Department of Obstetrics and Gynecology, University of Tampere, Tampere, Finland M Tuppurainen,f f Department of Obstetrics and Gynecology, University of Kuopio, Kuopio, Finland M Yliskoski,g g Central Hospital of Central Finland, Jyväskylä, Finland S Vuorma,h h National Public Health Institute, Helsinki, Finland J Paavonenaa Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finlanda Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland b Health Services Research Unit, STAKES, Helsinki, Finland c Department of Obstetrics and Gynecology, University of Turku, Turku, Finland d Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland e Department of Obstetrics and Gynecology, University of Tampere, Tampere, Finland f Department of Obstetrics and Gynecology, University of Kuopio, Kuopio, Finland g Central Hospital of Central Finland, Jyväskylä, Finland h National Public Health Institute, Helsinki, Finland
Dr K Halmesmäki, Department of Obstetrics and Gynecology, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. Email halmesma@mappi.helsinki.fi
Abstract
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.
