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Randomized studies have established the levonorgestrel-releasing intrauterine system (LNG-IUS) as an effective medical option for heavy menstrual bleeding. Compared with oral medical therapies, LNG-IUS often provides a larger reduction in menstrual blood loss and can improve quality of life. For gynecologists, it is especially useful in women who desire contraception or wish to avoid hysterectomy. Appropriate evaluation of structural causes, anemia and malignancy risk remains necessary before insertion. Counseling should cover irregular bleeding during the first months and the expected timeline of improvement. The evidence supports LNG-IUS as a practical fertility-sparing treatment for many women with nonmalignant heavy bleeding.

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Randomized studies have established the levonorgestrel-releasing intrauterine system (LNG-IUS) as an effective medical option for heavy menstrual bleeding. Compared with oral medical therapies, LNG-IUS often provides a larger reduction in menstrual blood loss and can improve quality of life. For gynecologists, it is especially useful in women who desire contraception or wish to avoid hysterectomy. Appropriate evaluation of structural causes, anemia and malignancy risk remains necessary before insertion. Counseling should cover irregular bleeding during the first months and the expected timeline of improvement. The evidence supports LNG-IUS as a practical fertility-sparing treatment for many women with nonmalignant heavy bleeding.
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