A pair of experts will debate the pros and cons of both the IUD and medical treatments for abnormal uterine bleeding AUB during this year’s Samuel A. Cosgrove Memorial Lecture.
The debate, “Medication Superheroes Take on the Mighty IUD for Treatment of AUB,” takes place from 9:10 to 10 am Saturday in Ballroom D.
AUB affects up to an estimated 30 percent of women at some point during their lives. Medical therapies, especially combined oral contraceptives, are commonly used to treat AUB; however, in recent years, the levonorgestrel-releasing intrauterine device (LNG-IUD) has become an increasingly popular treatment option.
Michael A. Thomas, MD, chief of the division of reproductive endocrinology and infertility at the University of Cincinnati College of Medicine will advocate for LNG-IUD. Advocating for the benefits of medical options for treating AUB will be Kristen A. Matteson, MD, MPH, director of the division of research for the Department of Obstetrics and Gynecology at The Warren Alpert Medical School of Brown University and Women & Infants Hospital in Rhode Island.
Dr. Thomas, a member of the research team that developed the LNG-IUD, believes it is a safe and effective treatment option, particularly for patients who not only want to control their bleeding but also maintain their fertility potential.
“As a reproductive endocrinologist, I always consider the effects that treatment might have on the patient’s fertility,” he said. “So when you look at the LNG-IUD versus a birth control pill or another oral means of trying to control abnormal uterine bleeding issues, even though it is a contraceptive agent, it’s also a great non-contraceptive option for patients. If the IUD is in, it will continue to control bleeding in most patients, but it can be removed, and their fertility potential goes right back to normal.”
The LNG-IUD is also a good option for AUB patients who want to avoid the potential side effects of oral medications, Dr. Thomas said.
“People who have issues with progestin-related problems, such as mood changes, nausea or bloating, may not have that with the IUD because very little of the medication gets into the peripheral blood stream,” he said. “The advantage of this type of local device that is inside the uterus is that it actually has a direct effect, as opposed to taking something by mouth, which has to go through the liver and may not have a good effect.”
Dr. Matteson agrees that the LNG-IUD might be appropriate for some patients, but cautions against assuming a “one-size-fits-all” approach to treating women with abnormal bleeding.
“The overarching issue with AUB, specifically heavy menstrual bleeding, is that women’s lives are adversely affected by it; for example, it may cause them to change their work schedule or change plans with their friends and their family, so it’s a symptom that can have a major impact on women and their day-to-day lives,” Dr. Matteson said. “I think it’s great that we have so many different treatment options, but any treatment that you are looking at giving to a woman with heavy menstrual bleeding needs to address what she is finding most bothersome about her symptom to reduce the adverse impact that bleeding has on her daily life.”